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Oral Health-Related Quality of Life and Mental Health Impairment in Patients Affected by Medication-Related Osteonecrosis of the Jaws: A Case-Control Pilot Study.

In the present case-control study, the impact of medication-related osteonecrosis of the jaws (MRONJ) on patients' oral health-related quality of life (OHRQoL), overall quality of life (QoL), and psychological status was evaluated using a set of questionnaires. These questionnaires included the Oral Health Impact Profile-14 (OHIP-14), the Short Form 36 Health Survey Questionnaire (SF-36), and the hospital anxiety and depression scale (HADS). A total of 25 MRONJ patients and 25 controls were included in the study. The results showed that MRONJ patients had a significantly poorer OHRQoL (OHIP-14

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… Total number of Patients | 25 (100) Oncologic patients | 17 (68.0) Solid tumor | 15 (60.0) Breast | 12 (48.0) Prostate | 3 (12.0) Bone metastasis | 13 (52.0) Multiple myeloma | 2 (8.0) Osteometabolic patients | 8 (32.0) Antiresorptive therapy (AR) | AR monotherapy | 23 (92.0) Zoledronate | 2 (8.0) Alendronate …

Advanced biomaterial-based approaches for medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating adverse effect linked to anti-resorptive and anti-angiogenic therapies, with an incidence of 4.34 % (6.22 % in oncology patients and 0.59 % in osteoporosis patients) based on a pooled analysis of 92 observational studies (2015-2020), characterized by persistent bone exposure and poor healing. Conventional treatment modalities often yield suboptimal outcomes, with recurrence and procedural morbidity. In recent years, biomaterial-based strategies have emerged as promising alternatives by targeting MRONJ's complex pathophysiolo

Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).

PurposeThe International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) have proposed procollagen type I N propeptide (PINP) and β isomerized C-terminal telopeptide of type I collagen (β-CTX-I) as reference bone turnover markers (BTMs) for osteoporosis. This report examines the published literature since the 2011 IOF-IFCC position paper in order to determine the clinical potential of the reference BTMs and newer markers for the prediction of fracture risk and monitoring the treatment of osteoporosis.MethodsEvidence for the re

Hypercalcaemia and hypocalcaemia: finding the balance.

Calcium metabolism in cancer and hypercalcaemia of malignancyThe balance between bone formation and resorption may be disrupted in patients with cancer, leading either to increased bone resorption, calcium release, and possibly hypercalcaemia, or to increased bone formation, sequestration of calcium, and possibly hypocalcaemia. In adults, hypercalcaemia of malignancy is most common in patients with tumours that produce factors that induce osteoclast activation and enhance bone resorption. Impaired renal function and increased renal tubular calcium resorption may further affect calcium levels.T

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… Impact of noncompliance with alendronate and risedronate on the incidence of nonvertebral osteoporotic fractures in elderly women. Br J Clin Pharmacol. 2008;66(1):117–127. doi: 10.1111/j.1365-2125.2008.03178.x. 90. Rossini M, Bianchi G, Di Munno O, Giannini S, Minisola S, Sinigaglia L, Adami S. …

Dental implants in patients treated with antiresorptive medication - a systematic literature review.

OBJECTIVE: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed. METHODS: The PICO design was used: (Patients) For which subclientel of patients with anti

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… Table 2 Included literature A: Alendronate; CCS: Case control study, CS: Case series; CSS: Cross sectional study; D: Denosumab; I: Ibandronate; LSBCD: Longitudinal single-blind controlled study; n.s.: Not specified; P: Pamidronate; PS: Prospective Study; R: Risedronate; RS: Retrospective study, Z: Zoledronate …

Biologics for bone regeneration: advances in cell, protein, gene, and mRNA therapies.

Bone fractures represent a significant global healthcare burden. Although fractures typically heal on their own, some fail to regenerate properly, leading to nonunion, a condition that causes prolonged disability, morbidity, and mortality. The challenge of treating nonunion fractures is further complicated in patients with underlying bone disorders where systemic and local factors impair bone healing. Traditional treatment approaches, including autografts, allografts, xenografts, and synthetic biomaterials, face limitations such as donor site pain, immune rejection, and insufficient mechanical

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… In clinical trials, patients receiving romosozumab exhibited a higher incidence of these adverse effects compared to those treated with alendronate. 110 As a result, this therapy should be used with caution in patients with a history of cardiovascular disease or other risk factors. … Effects of teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: thirty-six–month results of a randomized, double-blind, controlled trial. Arthritis Rheumatism 60 , 3346–3355 (2009). 96. Neer, R. M. et al. …

Antibodies to watch in 2020.

This 2020 installment of the annual 'Antibodies to Watch' series documents the antibody therapeutics approved in 2019 and in regulatory review in the United States or European Union, as well as those in late-stage clinical studies, as of November 2019*. At this time, a total of 5 novel antibody therapeutics (romosozumab, risankizumab, polatuzumab vedotin, brolucizumab, and crizanlizumab) had been granted a first approval in either the US or EU, and marketing applications for 13 novel antibody therapeutics (eptinezumab, teprotumumab, enfortumab vedotin, isatuximab, [fam-]trastuzumab deruxtecan,

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… In the ARCH study, 1 year of treatment with Evenity followed by 1 year of alendronate reduced the risk of a new vertebral fracture by 50% compared to two years of alendronate alone. More than 11,000 women with postmenopausal osteoporosis participated in the 2 studies. …

Anti-tumour activity of bisphosphonates in preclinical models of breast cancer.

There is increasing evidence of anti-tumour effects of bisphosphonates from pre-clinical studies, supporting a role for these drugs beyond their traditional use in treatment of cancer-induced bone disease. A range of model systems have been used to investigate the effects of different bisphosphonates on tumour growth, both in bone and at peripheral sites. Most of these studies conclude that bisphosphonates cause a reduction in tumour burden, but that early intervention and the use of high and/or repeated dosing is required. Successful eradication of cancer may only be achievable by targeting t

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… Zhang Q Shi S Yen Y Li X Zhang Y Zhou K Le AD Bisphosphonates suppress insulin-like growth factor 1-induced angiogenesis via the HIF-1alpha/VEGF signaling pathways in human breast cancer cells Int J Cancer 2010 126 90 103 10.1002/ijc.24710 19569175 PMC2784023 Tuomela JM Valta MP Väänänen K Härkönen PL Alendronate …

Parenteral Ozone Therapy Combined with Topical Antimicrobials Enhances Tissue Repair in Mandibular Osteonecrosis of Elderly Female Rats.

Medication-related osteonecrosis of the jaws (MRONJ) remains a challenging complication associated with antiresorptive therapy, highlighting the need for effective adjunctive preventive strategies. This study evaluated the effects of systemic ozone therapy, alone or combined with topical 10% metronidazole paste or 2% chlorhexidine gel, on alveolar repair in a zoledronate-induced rat model of MRONJ. Forty-two ovariectomized female Wistar rats were allocated into seven experimental groups. Following mandibular first molar extraction, animals received systemic ozone therapy and/or topical antimic

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… Raloxifene but not alendronate can compensate the impaired osseointegration in osteoporotic rats. Clin. Oral Investig. 2018;22:255–265. doi: 10.1007/s00784-017-2106-2. 13. …

γδ T cells in hematological malignancies: mechanisms and therapeutic strategies.

γδ T cells are a unique subset of lymphocytes with both innate and adaptive features. They recognize and eradicate various hematological malignancies through different mechanisms, employing factors including γδ TCR, NKR, NKG2D, TRAIL, and perforin/granzyme. They also modulate other immune cells to enhance their antitumor activity. Moreover, γδ T cells have potent antiviral functions after hematopoietic stem cell transplantation (HSCT), which may improve the outcome of patients with hematological malignancies. In this review, we summarize the current knowledge on γδ T cell biology and function

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… Lymphoma and MM γδ T cells stimulated by aminobisphosphonates such as pamidronate, alendronate, and ibandronate 63 or specific synthetic PAgs 64 in vitro showed specific cytotoxicity against lymphoma and myeloma cell lines. …

Exploring the genetic alterations of Gorham-Stout disease.

The "vanishing bone disease" or Gorham-Stout disease (GSD) is a very rare disorder characterized by massive lymphatic and angiomatous proliferation accompanied by progressive osteolysis, without the deposition of new bone matrix. Because of its rare and complex clinical features, diagnosis is challenging and its etiopathogenesis is not completely known; the genetic basis of GSD has been hypothesized and different mutations have been reported in patients. Our review aims to describe all these genetic alterations found in GSD patients and their association with clinical features. The identificat

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… The authors also reviewed GSD bisphosphonate treatment investigations in literature, finding that the most commonly used was zoledronic acid, followed by alendronate, which often led to disease arrest ( 30 ). …

Case Report with Literature Review: Tumor-induced osteomalacia from a soft-tissue phosphaturic mesenchymal tumor of the trunk.

BACKGROUND: Tumor-induced osteomalacia (TIO), a type of acquired hypophosphatemic osteomalacia, is brought on by tumors producing excessive levels of fibroblast growth factor 23, which raises renal phosphorus excretion. METHODS: Through a review of the literature, we have outlined the clinical characteristics of 33 patients with soft-tissue TIO of the trunk and described a case of TIO brought on by a soft-tissue tumor on the back. RESULTS: A 63-year-old woman who had been experiencing generalized bone pain for approximately three years visited the hospital. Physical examination revealed a ro

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… She received treatment with oral alendronate as well as calcium and vitamin D supplementation, but the therapeutic outcomes were unsatisfactory. The pain gradually intensified, accompanied by fatigue. The symptoms began with weakness in both lower limbs, gradually developing into general weakness. …

The Role of Macrophage in the Pathogenesis of Osteoporosis.

Osteoporosis is a systemic disease with progressive bone loss. The bone loss is associated with an imbalance between bone resorption via osteoclasts and bone formation via osteoblasts. Other cells including T cells, B cells, macrophages, and osteocytes are also involved in the pathogenesis of osteoporosis. Different cytokines from activated macrophages can regulate or stimulate the development of osteoclastogenesis-associated bone loss. The fusion of macrophages can form multinucleated osteoclasts and, thus, cause bone resorption via the expression of IL-4 and IL-13. Different cytokines, endoc

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… A model to monitor the efficacy of alendronate treatment in women with osteoporosis using a biochemical marker of bone turnover Bone 1999 24 603 609 10.1016/S8756-3282(99)00087-3 10375203 43. Greenblatt M.B. Shim J.H. …

A comprehensive overview on antibody-drug conjugates: from the conceptualization to cancer therapy.

Antibody-Drug Conjugates (ADCs) represent an innovative class of potent anti-cancer compounds that are widely used in the treatment of hematologic malignancies and solid tumors. Unlike conventional chemotherapeutic drug-based therapies, that are mainly associated with modest specificity and therapeutic benefit, the three key components that form an ADC (a monoclonal antibody bound to a cytotoxic drug via a chemical linker moiety) achieve remarkable improvement in terms of targeted killing of cancer cells and, while sparing healthy tissues, a reduction in systemic side effects caused by off-tum

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… In the same year, Lee et al. demonstrated in a model of rheumatoid arthritis (RA) the immunosuppressive efficacy of TCZ-ALD, an ADC that targets the IL-6 receptor (IL-6R) and is conjugated to the small molecule alendronate. …

Nanoparticle-Mediated Combination Therapy: Two-in-One Approach for Cancer.

Cancer represents a group of heterogeneous diseases characterized by uncontrolledgrowth and spread of abnormal cells, ultimately leading to death. Nanomedicine plays a significantrole in the development of nanodrugs, nanodevices, drug delivery systems and nanocarriers. Someof the major issues in the treatment of cancer are multidrug resistance (MDR), narrow therapeuticwindow and undesired side effects of available anticancer drugs and the limitations of anticancerdrugs. Several nanosystems being utilized for detection, diagnosis and treatment such as theranosticcarriers, liposomes, carbon nano

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… PEG-dendrimer, H(2)N-PEG-dendrimer-(COOH)(4) was used as a carrier for a combination of PTX and alendronate (ALN). …

How does medication-related osteonecrosis of the jaw (MRONJ) influence the health-related quality of life after surgery?

BACKGROUND: Medication-Related Osteonecrosis of the Jaw (MRONJ), an established side effect of antiresorptive and antiangiogenic medication, could sometimes require surgical intervention, such as decortication. The objectives of this retrospective patient survey study were to evaluate the effect of surgical treated MRONJ on health-related quality of life (QoL) and to assess the awareness of the risk of MRONJ. METHODS: The MRONJ-related QoL in both cancer and osteoporosis patients was determined in four different time periods after surgery applying the European Organisation for Research and Tr

Impact of physical exercise in cancer survivors during and after antineoplastic treatments.

Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom

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… Bone targeted agents include bisphosphonates (such as etidronate and alendronate) and denosumab. … ://doi.org/10.1177/1759720X14546350 25342997 10.1177/1759720X14546350 PMC4206646 8 Doria C Mosele GR Solla F Maestretti G Balsano M Scarpa RM Treatment of osteoporosis secondary to hypogonadism in prostate cancer patients: a prospective randomized multicenter international study with denosumab vs. alendronate …

Pedicled myofascial temporalis flap for closure of large maxillary defects after medication-related osteonecrosis of the jaws. A case series.

BACKGROUND: Medication-related osteonecrosis of the jaws (MRONJ) located in the maxilla may lead to challenging oro-antral and oro-nasal defects too extensive to be predictably closed with local soft tissue flaps. The use of a pedicled myofascial temporalis flap (PMTF) is, however, well-established for closing large maxillary defects following ablative craniomaxillofacial surgery. OBJECTIVES: The purpose of the present study was to evaluate the use of PMTF for maxillary defect closure in patients with stage 3 MRONJ. METHODS: A retrospective cohort study was conducted based on data from the C

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… Treated with Alendronate 70 mg weekly for a total of 57 months prior to surgery, with no steroid treatment, but receiving Letrozole treatment due to breast cancer. NRS 2 at the initial visit and spontaneously developed stage 3 MRONJ. …

Finite Element Analysis of Osteoporotic and Osteoblastic Vertebrae and Its Association With the Proton Density Fat Fraction From Chemical Shift Encoding-Based Water-Fat MRI - A Preliminary Study.

PurposeOsteoporosis is prevalent and entails alterations of vertebral bone and marrow. Yet, the spine is also a common site of metastatic spread. Parameters that can be non-invasively measured and could capture these alterations are the volumetric bone mineral density (vBMD), proton density fat fraction (PDFF) as an estimate of relative fat content, and failure displacement and load from finite element analysis (FEA) for assessment of bone strength. This study's purpose was to investigate if osteoporotic and osteoblastic metastatic changes in lumbar vertebrae can be differentiated based on the

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… Assessment of Vertebral Fracture Risk and Therapeutic Effects of Alendronate in Postmenopausal Women Using a Quantitative Computed Tomography-Based Nonlinear Finite Element Method. Osteoporos Int (2009) 20:801–10. doi: 10.1007/s00198-008-0750-8 21. Bailey S, Hackney D, Vashishth D, Alkalay RN. …

From Osteoclast Differentiation to Osteonecrosis of the Jaw: Molecular and Clinical Insights.

Bone physiology relies on the delicate balance between resorption and formation of its tissue. Bone resorption depends on a process called osteoclastogenesis in which bone-resorbing cells, i.e., osteoclasts, are produced by the differentiation of more undifferentiated progenitors and precursors. This process is governed by two main factors, monocyte colony-stimulating factor (M-CSF) and receptor activator of NFκB ligand (RANKL). While the former exerts a proliferating effect on progenitors/precursors, the latter triggers a differentiation effect on more mature cells of the same lineage. Bone h

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… Fedele et al. [ 75 ] described that use of alendronate, diagnosis of osteoporosis, and dental infection were more commonly found in patients with the NE-ONJ. Despite the extensive ongoing research, the mechanism that induces ONJ is still unclear. …