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Bisphosphonate-related osteonecrosis of the jaw mimicking bone metastasis.

Osteonecrosis of the jaw is usually a potential complication of bisphosphonate therapy. In a cancer patient, this disease entity can be misdiagnosed as a metastatic lesion. Our aim is to make clinicians aware of bisphosphonate associated osteonecrosis of the jaw to prevent misdiagnosis and initiate proper treatment at the earliest. We present the case of a breast cancer patient with multiple bony metastases and a jaw lesion presumed to be metastases. After no response to palliative radiation, repeat radiological imaging studies revealed osteonecrosis of the jaw. Correlating a patient's clinica

Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review of Pathophysiology, Risk Factors, Preventive Measures and Treatment Strategies.

Medication-related osteonecrosis of the jaw (MRONJ) is a major problem that can occur in people taking certain medications such bisphosphonates and denosumab. It can be used to treat osteoporosis or cancer. Bisphosphonate exposure, dental diseases and procedures, age, sex, anatomical factors, medical issues, and hereditary factors are all variables that enhance the risk of MRONJ. Even though MRONJ and antiresorptive medications have a close association, the pathophysiology of MRONJ is unknown. Careful dental preparation and oral hygiene instructions significantly minimize the risk of osteonecr

Каннабиноиды: терапевтические перспективы для борьбы с орофасиальной болью, оральное воспаление и систематическое обследование на предмет вылечения костей.

Каннабиноиды, в частности каннабидиол (КБР) и тетрагидроканнабинол (THC), все чаще изучаются на предмет их терапевтического применения в различных медицинских областях. Целью этого систематического обзора является изучение их роли в оральной хирургии с уделением особого внимания обезболиванию, воспалению и регенерации костей. Систематический обзор был проведен с использованием системы PRISMA для выявления соответствующих исследований из баз данных PubMed, Scopus и Web-сайта науки, опубликованных до ноября 2024. Обзор включал в себя клинические и предклинические исследования, посвященные изучен

Gut-Bone Axis: A Non-Negligible Contributor to Periodontitis.

Periodontitis is a polymicrobial infectious disease characterized by alveolar bone loss. Systemic diseases or local infections, such as diabetes, postmenopausal osteoporosis, obesity, and inflammatory bowel disease, promote the development and progression of periodontitis. Accumulating evidences have revealed the pivotal effects of gut microbiota on bone health via gut-alveolar-bone axis. Gut pathogens or metabolites may translocate to distant alveolar bone via circulation and regulate bone homeostasis. In addition, gut pathogens can induce aberrant gut immune responses and subsequent homing o

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… In severe form, persistent pathologic alveolar bone loss in periodontitis may result in tooth loss and subsequent damage of masticatory function, negatively affecting general health and quality of life. …

NAT10 Regulates LPS-Induced Inflammation via Stabilization of N4-Acetylated PTX3 mRNA in Human Dental Pulp Stem Cells.

Severe dental pulp inflammation can lead to tissue lysis and destruction, underscoring the necessity for effective treatment of pulpitis. N-acetyltransferase 10 (NAT10)-mediated N4-acetylcytidine (ac4C) modification has recently emerged as a key regulator in inflammatory processes. However, whether NAT10 affects the inflammatory response in human dental pulp stem cells (hDPSCs) remains unelucidated. In this study, elevated NAT10 expression was observed in pulpitis tissues and LPS-stimulated hDPSCs. Knockdown of NAT10 led to reduced inflammatory gene expression and lower reactive oxygen species

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… Without medical intervention, dental pulp inflammation may further progress to irreversible pulpitis and necrosis, leading to intolerable pain and potential tooth loss, which will significantly affect the quality of life [ 2 ]. …

Medication-related osteonecrosis of the jaw: Clinical and practical guidelines.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction, consisting of progressive bone destruction in the maxillofacial region of patients. ONJ can be caused by two pharmacological agents: Antiresorptive (including bisphosphonates (BPs) and receptor activator of nuclear factor kappa-B ligand inhibitors) and antiangiogenic. MRONJ pathophysiology is not completely elucidated. There are several suggested hypothesis that could explain its unique localization to the jaws: Inflammation or infection, microtrauma, altered bone remodeling or over suppression of bone resor

Influence of oral health on mucositis in patients undergoing hematopoietic progenitor cell transplantation (HPCT).

AimsTo establish whether or not the state of patient oral health can influence the occurrence and/or severity of oral mucositis during hematopoietic progenitor cell transplantation (HPCT).Materials and methodsThe study included 72 patients awaiting HPCT. Prior to transplantation, clinical exploration and radiology were carried out and oral photographs were taken. This evaluated the extent of caries present, the number of missing teeth and the number of dental fillings in each patient; CAO (Caries and Obturations Index) DMFS (Decayed, Missing, and Filled Surfaces) and Restoration Indices were c

Inflammaging in periodontal, periapical, and malignancy-associated disease: drivers of alveolar bone loss and repair.

BACKGROUND: Aging significantly impacts bone metabolism through altered osteoblast/osteoclast dynamics, reduced stem cell regeneration, and chronic inflammaging. This narrative review explores how these age-related changes influence alveolar bone loss and regeneration in the oral cavity. METHODS: The review investigates key mechanisms-including immunosenescence and inflammasome activation-across three specific pathological contexts: (1) periodontitis, (2) periapical bone resorption, and (3) malignancy-associated osteolysis. Preclinical and clinical evidence were integrated to analyze the bone

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… First, they may have a pre-existing low bone density or osteoporosis, which means that less reserve is available before a pathological fracture or tooth loss occurs from tumor osteolysis. Second, the ability of the peritumoral bone to mount reactive bone formation can be diminished. …

Conservative treatment of bisphosphonate-related osteonecrosis of the jaw in multiple myeloma patients.

The use of intravenous bisphosphonates (pamidronate or zoledronic acid) is the cornerstone for the management of multiple myeloma-(MM-) related bone disease. However, osteonecrosis of the jaw (ONJ) is a rare, but sometimes difficult to manage, adverse effect of bisphosphonates therapy. A retrospective review of all MM patients who were treated with bisphosphonates in our department, from 2003 to 2013, and developed ONJ was performed. According to inclusion criteria, 38 patients were studied. All these patients were treated as conservatively as possible according to the American Association of

Уровни гингивальной креветочной жидкости пролактина у пациентов, страдающих периодонтитом, с контролируемым или неконтролируемым типом 2 диабет. Контролируемое клиническое испытание.

В ходе этого исследования были исследованы уровни гингивальной кревикулярной жидкости (ГХФ) гормона пролактина (ПРЛ) на этапе III периодонтит (П) пациентов с типом 2 сахарный диабет (T2DM) до и 3 через несколько месяцев после нехирургической периодической терапии (НППТ). В этом деле под контролем суда, 80 Темы были разделены на 4 группы: группа I: здоровый контроль; группа II: системно здоровый этап III P пациентов; группа III: этап III P пациентов с контролируемым Т2ДМ; группа IV: этап III P пациентов с неконтролируемым Т2ДМ. Все пациенты П получили NSPT. Three Спустя несколько месяцев после

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… Bacterial- derived factors stimulate a local inflammatory reaction, cytokine release, followed by recruitment and activation of T and B lymphocytes causing periodontal tissue destruction and eventual tooth loss. …

Pathogenesis and treatment of multiple myeloma bone disease.

Multiple myeloma (Plasma cell myeloma), a malignancy of the plasma cells, exhibits tumor expansion preferentially in the bone marrow and the development of bone-destructive lesions. Multiple myeloma is still an incurable disease with changes in the bone marrow microenvironment in favor of the survival and proliferation of multiple myeloma cells and bone destruction. In this review, we described the recent findings on the regulators involved in the development of myeloma bone diseases, and succinctly summarize currently available therapeutic options and the development of novel bone modifying a

Macrophage miR-149-5p induction is a key driver and therapeutic target for BRONJ.

Bisphosphonate-related (BP-related) osteonecrosis of the jaw (BRONJ) is one of the severe side effects of administration of BPs, such as zoledronic acid (ZA), which can disrupt the patient's quality of life. Although the direct target of skeletal vasculature and bone resorption activity by BPs has been phenomenally observed, the underlying mechanism in BRONJ remains largely elusive. Thus, it is urgently necessary to discover effective therapeutic targets based on the multifaceted underlying mechanisms in the development of BRONJ. Here, we determined the inhibitory role of ZA-treated macrophage

Impact of discontinuing 5 years of enzyme replacement treatment in a cohort of 6 adults with hypophosphatasia: A case series.

Asfotase alfa is a human recombinant enzyme replacement therapy for hypophosphatasia. We describe 6 adults who were treated with asfotase alfa for 61-68 months in a clinical trial (NCT01163149), after which asfotase alfa was discontinued for 15-48 months. The patients experienced clinical deterioration and, when treatment was restarted, showed improvement. Patients with hypophosphatasia should be closely monitored if asfotase alfa is stopped as clinical decline is likely. Clinical practice guidelines are needed.

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… Patient 3 This patient was diagnosed with HPP following premature tooth loss at age 2 years; he was found to be a compound heterozygote for pathogenic ALPL missense variants (c.571G>A and c.1001G>A). …

Biomarkers of Chemotherapy-Induced Peripheral Neuropathy: Current Status and Future Directions.

Chemotherapy induced peripheral neuropathy (CIPN) is an often severe and debilitating complication of multiple chemotherapeutic agents that can affect patients of all ages, across cancer diagnoses. CIPN can persist post-therapy, and significantly impact the health and quality of life of cancer survivors. Identifying patients at risk for CIPN is challenging due to the lack of standardized objective measures to assess for CIPN. Furthermore, there are no approved preventative treatments for CIPN, and therapeutic options for CIPN remain limited once it develops. Biomarkers of CIPN have been studie

R-spondin signaling as a pivotal regulator of tissue development and homeostasis.

R-spondins (Rspos) are cysteine-rich secreted glycoproteins which control a variety of cellular functions and are essential for embryonic development and tissue homeostasis. R-spondins (Rspo1 to 4) have high structural similarity and share 60% sequence homology. It has been shown that their cysteine-rich furin-like (FU) domain and the thrombospondin (TSP) type I repeat domain are essential for initiating downstream signaling cascades and therefore for their biological functions. Although numerous studies have unveiled their pivotal role as critical developmental regulators, the most important

Managing bisphosphonate-related osteonecrosis of the jaws with xenografts: a case report.

It is possible to manage large bone destruction induced by BRONJ using xenograft grafting to promote a bone formation.

Concurrent chronic lymphocytic leukemia and primary hyperparathyroidism in a mule.

A 26-year-old mule gelding was evaluated for chronic weight loss and decreased appetite. The mule had been losing weight and intermittently hypophagic for approximately 7 months. Laboratory analysis of whole blood and plasma identified severe total hypercalcemia, marked hypophosphatemia, markedly increased parathyroid hormone concentration, and marked lymphocytosis. A sestimibi scan intended to identify parathyroid gland tissue was nondiagnostic. Results of flow cytometry and PCR for antigen receptor rearrangement (PARR) were consistent with a B cell lymphoproliferative disorder, likely chroni

The interplay of immunity and growth: a case of combined variable immunodeficiency and growth hormone deficiency.

INTRODUCTION: Common variable immunodeficiency (CVID) is one of the more common immunodeficiencies seen in clinical practice with a complex disease pathology; while growth hormone deficiency (GHD) is a disorder characterized by complete or relative absence of the human growth hormone. CASE PRESENTATION: This case report presents a 13-year-old female patient with a long history of recurrent respiratory tract and ear infections, along with a notable failure to hit her developmental milestones early in the second decade of her life. The diagnosis was based on a thorough investigation of serum im

Medication-related Osteonecrosis of the Jaw: A Review.

Medication-related osteonecrosis of the jaw (MRONJ) is a rare, severe debilitating condition from unknown causes. It is characterized by nonhealing exposed bone in a patient with a history of antiresorptive or antiangiogenic agents in the absence of radiation exposure to the head and neck region. The first case of MRONJ was reported in the early 2000s. Diagnostic criteria for MRONJ was developed by the American Association of Oral and Maxillofacial Surgeons (AAOMS) based on pharmacological history as well as clinical and radiographic features. Antiresorptive medications such as bisphosphonate

The Role of the Immune Response in the Development of Medication-Related Osteonecrosis of the Jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious adverse drug effect. There are multiple hypotheses to explain the development of MRONJ. Reduced bone remodeling and infection or inflammation are considered central to the pathogenesis of MRONJ. In recent years, increasing evidence has shown that bisphosphonates (BPs)-mediated immunity dysfunction is associated with the pathophysiology of MRONJ. In a healthy state, mucosal immunity provides the first line of protection against pathogens and oral mucosal immune cells defense against potentially invading pathogens by media