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Воображаемые аспекты изменений кости maxillomandibular у пациентов с множественной миеломой, обработанных бисфофонами: систематический обзор.

ЦЕЛЬ: Множественная миелома (ММ) представляет собой редкий рак, который, как правило, проходит с помощью бисфофонатов, с тем чтобы замедлить ресорбцию костей и предотвратить осложнения скелета. Цель этого исследования состояла в том, чтобы выявить характерные особенности изображений у пациентов, получающих биофосфонатную терапию. МАТЕРИАЛЫ И МЕТОДЫ: Этот систематический обзор включал в себя исследования по изучению изменений костных костей в максиломандибулярных костях на основе фотографических обследований пациентов ММ, проходящих лечение с использованием бисфофонатов. Отобранные исследования

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… Furthermore, the posterior region of the maxilla appears to be more affected than the anterior region, possibly due to increased bone resorption and remodeling processes following early tooth loss. 13 Some authors have noted that the body, angle, and ramus of the mandible are the most frequently affected …

Osteonecrosis of the jaws in patients treated with bisphosphonates.

The literature describes an increasing presence of bisphosphonate-induced osteonecrosis of the jaws (ONJ), characterized by the exposure for over 8 weeks of necrotic bone in the maxillofacial region, after bisphosphonate therapy, in the absence of prior maxillary radiotherapy. The present literature review examines the etiopathogenesis, risk factors, clinical forms, diagnosis, treatment and prevention of bisphosphonate-induced ONJ. In addition, a review is made of all the series involving over 15 patients diagnosed with this disorder between 1 January 2011 and 15 May 2011. A PubMed-Medline sea

Indian Society of Periodontology Good Clinical Practice Recommendations for dental pain management and use of analgesics.

Pain is one of the most frequent reasons for seeking dental care and significantly influences patient comfort, treatment acceptance, and clinical outcomes. Effective management of dental pain requires accurate diagnosis, timely intervention, and the rational use of analgesics supported by evidence-based clinical decision-making. Recognizing the need for structured guidance for everyday dental practice, the Indian Society of Periodontology has developed Good Clinical Practice Recommendations on Pain Management and the Use of Analgesics in Dental Clinics. These recommendations were formulated by

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… Association between dental pain and tooth loss with health-related quality of life: The Korea national health and nutrition examination survey: A population-based cohort study. Medicine (Baltimore) 2016;95:e4707. Comassetto MO, Hugo FN, Neves M, Hilgert JB. …

Oral Ulceration with Bone Sequestration: Key Insights for Clinicians and Their Relevance in Contemporary Clinical Practice-A Narrative Systematic Review.

Background: Oral ulceration with bone sequestration (OUBS) is an uncommon clinical lesion characterized by painful mucosal ulceration associated with exposed and necrotic bone in the oral cavity, often without known factors inducing osteonecrosis. Despite its potential for diagnostic confusion with more serious lesions, such as medication-related osteonecrosis, OUBS remains poorly understood and underreported. Objectives: To systematically review the literature on OUBS and identify its main clinical and radiographic characteristics to assist in early diagnosis and appropriate management. Metho

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… This finding is not surprising, since the incidence of oral ulcers tends to increase with advancing age, due to factors such as weakening of the mucosa, immunological compromise, and greater likelihood of tooth loss [ 45 ]. …

A Retrospective Observational Study of Risk Factors for Denosumab-Related Osteonecrosis of the Jaw in Patients with Bone Metastases from Solid Cancers.

This single-center retrospective observational study aimed to identify risk factors for developing denosumab-related osteonecrosis of the jaw (DRONJ) in stage IV solid cancer patients with bone metastases. In total, 123 consecutive patients who had received 120 mg of denosumab every 4 weeks at least twice between July 2014 and October 2018 were included. We surveyed their demographics, medical history, blood test, underlying disease, and intraoral findings. Fourteen patients (11.4%) developed DRONJ within a mean denosumab administration period of 4 months (range: 2-52 months). Univariate analy

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… After 16 months of denosumab administration, intraoral mandibular necrotic bone exposure, together with progressive spontaneous tooth loss was first observed during oral follow-up (( a ) intraoral photo; ( b ) panoramic radiograph). …

Could Local Application of Hypoxia Inducible Factor 1-α Enhancer Deferoxamine Be Promising for Preventing of Medication-Related Osteonecrosis of the Jaw?

This experimental study investigates the prophylactic effect of deferoxamine (DFO) on medication-related osteonecrosis of the jaw (MRONJ). Thirty-six female Sprague Dawley rats received zoledronic acid (ZA) for eight weeks to create an osteonecrosis model. DFO was locally applied into the extraction sockets with gelatin sponge (GS) carriers to prevent MRONJ. The specimens were histopathologically and histomorphometrically evaluated. Hypoxia-inducible factor 1-alpha (HIF-1α) protein levels in the extraction sockets were quantified. New bone formation rate differed significantly between groups (

Osteonecrosis of the Jaw Associated with Antiangiogenics in Antiresorptive-Naïve Patient: A Comprehensive Review of the Literature.

OBJECTIVES: To review the available literature on medication-related osteonecrosis of the jaw (MRONJ) associated with antiangiogenics in antiresorptive-naïve individuals. METHODS: A literature search was performed using MEDLINE via PubMed, EMBASE, and Web of Science in December 2017. RESULTS: We identified reports describing a total of 35 antiresorptive drugs-naïve patients who developed antiangiogenic-related MRONJ. The mean age of these patients was 59.06 years and the F : M ratio was 4 : 5. The most common underlying disease was metastatic renal cell cancer. Pain to the mandible was the m

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… Moreover, there were 6 patients (17.14%) presenting with multiple symptoms including pain to the jaw, halitosis, spontaneous tooth loss, ulceration, difficulty in chewing, and paraesthesia. …

Impact of bisphosphonate drugs on dental implant healing and peri-implant hard and soft tissues: a systematic review.

OBJECTIVE: Implantology represents the gold standard for oral rehabilitation, unfortunately, often, despite there are no local contraindications to this type of rehabilitation, there are uncertainties regarding the general health of our patients. Many patients nowadays take bisphosphonate drugs, often without first seeking advice from an oral surgeon or a dentist. The purpose of this review is precisely to highlight any contraindications to this type of treatment reported in the literature, in patients who take or have taken bisphosphonate drugs. METHODS: For this study the scientific informa

Мандибулярная плазмоцитома как первоначальное проявление несекретарской множественной миеломы: Редкая диагностика.

Плазменные клеточные новообразования, связанные с челюстями, редки, при этом мантибулярное участие представляет собой редкое первоначальное проявление системной множественной миеломы (ММ). Их неспециальная клиническая и радиография часто имитирует более распространенные одонтогенные и подстрекательские условия, что затрудняет раннюю диагностику. Мы сообщаем о случае с 81-летним мужчиной, который испытывал боль и опухоль на левой задней челюсти в течение двух месяцев. Клиническое обследование выявило диффузный отек левого челюсти и угла. Ортопантомография (ОПГ) продемонстрировала четко определе

Osteoimmunopathology in HIV/AIDS: A Translational Evidence-Based Perspective.

Infection with the human immunodeficiency virus-1 (HIV) and the resulting acquired immune deficiency syndrome (AIDS) alter not only cellular immune regulation but also the bone metabolism. Since cellular immunity and bone metabolism are intimately intertwined in the osteoimmune network, it is to be expected that bone metabolism is also affected in patients with HIV/AIDS. The concerted evidence points convincingly toward impaired activity of osteoblasts and increased activity of osteoclasts in patients with HIV/AIDS, leading to a significant increase in the prevalence of osteoporosis. Research

Calcium Phosphate Bone Substitutes in the Prevention of Bisphosphonate-Related Osteonecrosis of the Jaw: A Review.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is characterized by exposed necrotic bone that often progresses with increasing pain and impaired quality of life. Zoledronate, the most potent and widely used bisphosphonate, has been strongly associated with BRONJ development following invasive dental procedures. Given the rising incidence of BRONJ, understanding and implementing effective preventive strategies have become imperative. Biomaterials based on synthetic hydroxyapatite and beta-tricalcium phosphate have been investigated as potential preventive agents. Their therapeutic rati

The Role of Dental Practitioners in the Management of Oncology Patients: The Head and Neck Radiation Oncology Patient and the Medical Oncology Patient.

This narrative review addresses the role of a dentist in the management of oncology patients, highlighting the oral complications that arise in head and neck radiation oncology patients and medical oncology patients. The prevention and management of these complications are discussed.

Medication-Related Osteonecrosis of the Jaws in Patients on Antiresorptive Medication With Dental Implants. A Scoping Review.

OBJECTIVES: Patients receiving antiresorptive medication (AR) for osteoporosis or cancer are at risk of medication-related osteonecrosis of the jaws (MRONJ), especially after surgical procedures. Dental implant (DI) placement in high-dose AR (HDAR) patients is widely discouraged, and thorough counseling is recommended for low-dose AR (LDAR) patients. However, data on the role of AR type, dose, and duration remain limited. This review evaluates MRONJ associated with DIs, focusing on AR type and accumulated dose, and identifies local and systemic risk factors. MATERIALS AND METHODS: This review

Adjuvant A-PRF Application in Patients with Various Stages of Medication-Related Osteonecrosis of the Jaw (MRONJ): Case Series.

Background and Clinical Significance: Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of antiresorptive therapies such as Zolendronic acid, used for bone metastases. Its management remains challenging, with outcomes often unpredictable. Platelet-rich fibrin (PRF), rich in growth factors, has been proposed as a potential adjunct to surgical treatment, aiming to promote tissue regeneration and improve patient outcomes. Case Presentation: We reported three clinical cases of MRONJ in patients previously treated with Zolendronic acid. All patients underwent surgical seq

Decompression, an Unusual Treatment Option for Multicystic Ameloblastoma: Concepts and Controversies.

Background: The most common odontogenic tumor is the solid ameloblastoma. This is concerning due to the progressive bone destruction in its intraosseous variant; this type of pathology often gets a delayed diagnosis due to the asymptomatic characteristic it has. Objective: The aim of the article is to propose a conservative treatment for multicystic ameloblastoma, reviewing the latest concepts, controversies, and treatment options described in the literature. Case Report: A patient arrives to our department with a diagnosis of unicystic ameloblastoma, so decompression and subsequent enucleatio

Medication-Related Osteonecrosis of the Jaw: A Cross-Sectional Survey among Urologists in Switzerland, Germany, and Austria.

Medication-related osteonecrosis of the jaw (MRONJ) is a potentially preventable adverse side effect of mainly antiresorptive drugs. MRONJ is expected to become a growing clinical problem due to the aging population and the increasing number of patients requiring antiresorptive agents. Knowledge and awareness about MRONJ and elimination of the oral and dental risk factors before starting antiresorptive therapy (AR) are fundamental to reducing the incidence of MRONJ. In urology, ARs are used primarily in patients suffering from bone metastases due to prostate cancer and to prevent cancer-treatm

Risk factors for medication-related osteonecrosis of the jaw and salivary IL-6 IN cancer patients.

INTRODUCTION: Medication-related osteonecrosis of the jaws is a severe complication of the use of antiresorptive and antiangiogenic therapy, with limited treatment options and great impact on patient's quality pf life. OBJECTIVE: The aim of this study was to assess the risk factors associated with medication-related osteonecrosis of the jaws in oncologic patients undergoing bisphosphonate treatment. In addition, salivary levels of interleukin-6, IL-6, were measured to investigate their association with severity and risk of medication-related osteonecrosis of the jaws. METHODS: Case-control s

Weekly teriparatide injections successfully treated advanced bisphosphonate-related osteonecrosis of the jaws.

This study investigated whether weekly teriparatide (TPTD) injections are as effective as daily teriparatide injections for the treatment of stage 3 bisphosphonate-related osteonecrosis of the jaws (BRONJ) and compared serum markers of bone turnover between the two treatment regimens. Daily TPTD treatment has recently been reported to be effective for BRONJ, but there are no reports describing the effectiveness of weekly TPTD injections. We report two patients with stage 3 BRONJ. One patient was successfully treated with weekly TPTD injections and the other with daily TPTD injections. Changes

Brazilian Academy of Neurology recommendations for diagnosis, management, and treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune disorder that leads to progressive motor and sensory impairment, resulting in significant morbidity. While the incidence rates vary, CIDP remains a challenging condition requiring a standardized and optimized approach to diagnosis and management. In Brazil, a middle-income country with substantial regional disparities in healthcare access, the availability of specialized neuromuscular centers is uneven, creating obstacles to timely and effective treatment. To address these challenges, the Brazilian Acade

Interleukin-17 plays a role in dental pulp inflammation mediated by zoledronic acid: a mechanism unrelated to the Th17 immune response?

ObjectiveTo evaluate the influence of RORγT inhibition by digoxin on inflammatory changes related to interleukin-17 (IL-17) in the pulp of rats treated with zoledronate (ZOL).MethodologyForty male Wistar rats were divided into a negative control group (NCG) treated with saline solution, a positive control group (PCG) treated with ZOL (0.20 mg/kg), and three groups treated with ZOL and co-treated with digoxin 1, 2, or 4 mg/kg (DG1, 2, and 4). After four intravenous administrations of ZOL or saline solution in a 70-day protocol, the right molars were evaluated by histomorphometry (number of bloo