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The "CROMa" Project: A Care Pathway for Clinical Management of Patients with Bisphosphonate Exposure.

Aim. To describe 7 years of activity of "CROMa" (Coordination of Research on Osteonecrosis of the Jaws) project of "Sapienza" University of Rome. Materials and Methods. A preventive and therapeutic care pathway was created for patients with bisphosphonates (BPs) exposure. Demographic, social, behavioural, pharmacological, and clinical variables were registered in a dedicated database. Results. In the project, 502 patients, 403 females and 99 males, were observed. Bone pathologies were 79% osteometabolic diseases (OMD) and 21% metastatic cancer (CA). Females were 90% in OMD group and 41% in CA.

An Approach for the Prevention, Diagnosis, and Treatment of Jaw Osteonecrosis: Report of a Case Associated with Zoledronic Acid.

BACKGROUND Osteonecrosis of the jaw is a condition manifesting as necrotic bone for 8 weeks or more, with no history of radiotherapy. It is linked to the use of antiresorptive drugs, such as bisphosphonates and denosumab. We discuss in this case report the importance of infection control during clinical procedures in patients taking antiresorptives. CASE REPORT Our case report describes a 52-year-old woman who had received zoledronic acid injections for 7 years, who presented with osteonecrosis of the jaw in the region of teeth 24, 25, and 26, with no local trauma. The report proceeds to descr

Endodontic therapy and Medication-related osteonecrosis of the jaw onset: a scoping review and expert opinion-based qualitative meta-synthesis.

INTRODUCTION: Medication-related osteonecrosis of the Jaw (MRONJ) is a serious side effect of bone-modifying agents (BMAs), including bisphosphonates, denosumab, and antiangiogenic drugs. Some dental procedures are recognized as local risk factors for MRONJ. Given the lack of specific guidelines for root canal therapy in patients treated with BMA, this scoping review aimed to investigate the risk of MRONJ associated with failed root canal therapy. Subsequently, a meta-synthesis of expert opinions was performed to identify existing recommendations and pitfalls of root canal therapy in patients

Molecular Mechanisms Leading from Periodontal Disease to Cancer.

Periodontitis is prevalent in half of the adult population and raises critical health concerns as it has been recently associated with an increased risk of cancer. While information about the topic remains somewhat scarce, a deeper understanding of the underlying mechanistic pathways promoting neoplasia in periodontitis patients is of fundamental importance. This manuscript presents the literature as well as a panel of tables and figures on the molecular mechanisms of Porphyromonas gingivalis and Fusobacterium nucleatum, two main oral pathogens in periodontitis pathology, involved in instigati

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… Fusobacterium spp., Prevotella intermedia / nigrescens , Porphyromonas gingivalis ( P. gingivalis ) and Aggregatibacter actinomycetemcomitans were described as the most prevalent subgingival pathogens found in patients with chronic periodontal disease that developed periodontal abscesses [ 7 , 8 ]. … Clinical and microbiological characterization of periodontal abscesses J. Clin. Periodontol. 2005 32 1213 1218 10.1111/j.1600-051X.2005.00839.x 16268997 8. Highfield J. Diagnosis and Classification of Periodontal Disease Aust. Dent. J. 2009 54 S11 S26 10.1111/j.1834-7819.2009.01140.x 19737262 9. …

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

BLAB2CancerKD: a knowledge graph database focusing on the association between lactic acid bacteria and cancer, but beyond.

In a broad sense, lactic acid bacteria (LAB) is a general term for Gram-positive bacteria that can produce lactic acid by utilizing fermentable carbohydrates. It is widely used in essential fields such as industry, agriculture, animal husbandry and medicine. At the same time, LAB are closely related to human health. They can regulate human intestinal flora and improve gastrointestinal function and body immunity. Cancer, a disease in which some cells grow out of control and spread to other body parts, is one of the leading causes of human death worldwide. In recent years, the potential of LAB i

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center.

OBJECTIVES: : The aim of this study was to evaluate the profile of patients on antiresorptive therapies for cancer treatment and assess presence of oral lesions, oral hygiene status, and knowledge regarding medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: This was an observational cross-sectional study that evaluated patients treated with antiresorptive medication at a single cancer hospital. Clinical data were collected and oral examination was performed to assess patient oral health. RESULTS: From July 2017 to December 2018, 90 patients were assessed; 64 were fem

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… The presence of one or more residual roots, teeth with open cavities, or periodontal abscesses were categorized as poor hygiene. …

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview.

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors pre

Osteomyelitis of the Jaw in COVID-19 Patients: A Rare Condition With a High Risk for Severe Complications.

Osteomyelitis of the jaw is an uncommon infection that arises from the flora of the oral cavity or sinuses and affects immunocompromised and polymorbid patients. Treatment includes surgical debridement and long regiments of broad-spectrum antibiotics. We present three cases of complicated jaw osteomyelitis presented with concurrent COVID-19 infection, including only two reported cases of odontogenic COVID-related osteomyelitis. The two mandibular cases were patients in their 30s with no comorbidities. The first case was an asymptomatic COVID-19-positive patient who developed an odontogenic inf

Bilateral jaw involvement of Burkitt's lymphoma in a 5-year-old: Rare pediatric case with review of the literature.

INTRODUCTION AND IMPORTANCE: Burkitt lymphoma (BL) is a rapidly progressing tumor that requires urgent diagnosis and treatment. It is the first human neoplasm linked to a viral cause and is classified into three subtypes: sporadic, endemic, and immunodeficiency-associated. CASE PRESENTATION: We report a rare case of a 5-year-old boy who presented to the Oral and Maxillofacial Surgery Department with a two-month history of bilateral maxillary swelling and pain. He had no significant medical history. An incisional biopsy confirmed the diagnosis of Burkitt's lymphoma. The patient underwent chemo

Multiple myeloma with presentation in the oral cavity.

Plasma cell neoplasms may present in the bone as monoclonal gammopathy of undetermined significance, solitary plasmacytoma of bone, multifocal plasma cell neoplasm of bones known as multiple myeloma (MM) and in soft tissues as extramedullary plasmacytoma. MM is a malignant disease of atypical plasma cells characterized by their multifocal proliferation and production of monoclonal immunoglobulins. Often, the initial clinical feature of this disease is subtle and requires trained primary health-care providers to identify this illness and put together a suitable treatment plan. This case report

Proteomic and transcriptomic analyses to explain the pleiotropic effects of Ankaferd blood stopper.

Ankaferd blood stopper is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica and has been used as a topical hemostatic agent and with its clinical application established in randomized controlled trials and case reports. Ankaferd has been successfully used in gastrointestinal endobronchial mucosal and cutaneous bleedings and also in abdominal, thoracic, dental and oropharyngeal, and pelvic surgeries. Ankaferd's hemostatic action is thought to form a protein complex with coagulation factors that facilitate adhesion of

Dissociations of oral foci of infections with infectious complications and survival after haematopoietic stem cell transplantation.

IntroductionHaematopoietic stem cell transplantation (HSCT) recipients are at increased risk for severe infections. This study examined the associations of common oral infections with survival and infectious complications in HSCT recipients.Materials and methodsAll autologous and allogeneic HSCT recipients transplanted in the University Hospital of Basel, Switzerland, between 2008 and 2016 and referred to oral infection control pre-HSCT were included in this retrospective case-control study. All patients had a clinical and a panoramic radiological dental examination taken immediately prior to

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… Acute oral foci of infections included: 1. fistula with purulent drainage, 2. symptomatic periapical granuloma, 3. symptomatic deep caries, 4. fresh extraction socket and 5. acute periodontal abscess with purulent drainage. …

Rare diseases: a challenge in paediatric dentistry.

Rare diseases are an often an overlooked public health problem. Although they are infrequent, occurring on average in 100-500 people per million, these diseases represent a significant challenge in paediatric dentistry due to their complex manifestations and the need for specialised care. Conditions such as X-linked hypophosphatemic rickets (XLH), hypophosphatasia (HPP), and osteogenesis imperfecta (OI) exemplify the intersection of systemic health issues and oral health, requiring a multidisciplinary approach for their effective management. Dentists frequently play a crucial role in identifyi

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

A Narrative Review of Osteonecrosis of the Jaw: What a Clinician Should Know.

Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon complication of antiresorptive therapy (ART) in patients receiving higher and more frequent doses of osteoclast inhibitors. The jaws are the most common site, as they have high bone turnover. The oral structures are exposed to various types of stresses, like mastication and dental diseases, which lead to microtrauma and increased bone remodeling. The hallmark feature of MRONJ is the area of exposed, necrotic, nonhealing, asymptomatic bone for more than eight weeks. Objective signs are pain in the jaw and oral cavity, loose teet

Multiple-Drugs-Related Osteonecrosis of the Jaw in a Patient Affected by Multiple Myeloma: A Case Report.

A 60-year-old woman suffering from multiple myeloma (MM) was treated with zoledronic acid (bisphosphonate), dexamethasone (corticosteroid), bortezomib (a chemotherapeutic agent), and lenalidomide (thalidomide analog) for about a year and with lenalidomide alone as maintenance therapy for almost two years and developed stage three medication-related osteonecrosis of the jaws (MRONJ) in the upper left dental arch approximately two weeks after tooth extraction, which was treated with a medical nonoperative conservative approach until reversion to stage one. The present case report describing the

Asia-Pacific consensus statement on medication-related osteonecrosis of the jaw in patients with osteoporosis.

A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term "Asia-Pacific" refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize r

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… . ● Carefully assess the following radiographic signs: – Ill-defined periapical radiolucencies – Marked osteosclerosis – Widening of the periodontal ligament (PDL) space Fig. 1 Marked osteosclerosis was observed around the root associated with a periodontal abscess (white arrow). … Fig. 1 Fig. 1 Marked osteosclerosis was observed around the root associated with a periodontal abscess (white arrow). Osteonecrosis of the jaw was noted on the buccal aspect of the corresponding mandibular region. …

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Более широкие соображения в отношении интеграции медицинских и стоматологических данных

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