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Chinese expert consensus on the diagnosis and clinical management of medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a side effect that occurs after treatment for systemic diseases. However, most institutions currently rely on empirical methods to make diagnosis and treatment plans, and there is a lack of consensus or guidelines for the classification, staging and treatment of MRONJ in China. To address this gap and improve prognosis, an expert panel representing 11 renowned domestic medical colleges and affiliated hospitals in China was convened. The panel made a comprehensive literature review of previous treatment experiences and research findings to

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… discharge Bone exposure, fistula or purulent discharge Pain Affected tooth Possible formation of sequestered bone Loose or lost teeth within the lesion region Loose tooth Fistula formation and purulent discharge Skin numbness Lower lip numbness Possible formation of sequestered bone Interstitial infection Trismus … fistula or purulent discharge | Pain Affected tooth | Possible formation of sequestered bone | Loose or lost teeth within the lesion region | Loose tooth Fistula formation and purulent discharge | | Skin numbness | Lower lip numbness Possible formation of sequestered bone | | Interstitial infection | Trismus …

Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ), which was first reported as bisphosphonate-related osteonecrosis of the jaw (BRONJ) in bisphosphonate users, is a rare but severe soft and hard tissue disease induced by several types of medications. There has been a deluge of information about MRONJ, such as epidemiology, risk factors, clinical recommendations for dental treatment to prevent it, and treatment strategies in medication-prescribed users. The aim of this study was to comprehensively review recent articles and provide the current scientific information about MRONJ, e

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… Table 1 Clinical and imaging findings of MRONJ in each stage Staging | Clinical symptoms | Imaging findings Stage 0 | no bone exposure/necrosis, deep periodontal pocket, loose tooth, oral mucosal ulcer, swelling, abscess formation, trismus, hypoesthesia/numbness of the lower lip (Vincent’s symptom), …

The Effect of Er:YAG Laser Therapy as an Adjunct to Surgical Treatment Compared to Latter Alone in Managing Medication-Related Osteonecrosis of the Jaw: A Randomised Controlled Clinical Trial.

OBJECTIVE: The aim of this double-blind randomised controlled clinical trial was to assess the effectiveness of the Er:YAG laser as an adjunct to conventional surgical treatment compared to surgical treatment alone in managing medication-related osteonecrosis of the jaw (MRONJ). METHODS: Sixty-five patients diagnosed with stage II or III MRONJ were randomly allocated into 2 groups: a control group (n = 30) treated using conventional surgery alone and a test group (n = 35) treated using conventional surgery with adjunctive Er:YAG laser. All patients received 3-day preoperative and 14-day posto

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… Is the Er: YAG laser effective in reducing pain, edema, and trismus after removal of impacted mandibular third molars? A meta-analysis. J Oral Maxillofac Surg. 2022;80(3):501–516. doi: 10.1016/j.joms.2021.10.006. 25. Golob Deeb J., Smith J., Belvin B.R., Lewis J., Grzech-Leśniak K. …

Review of cancer therapies for the perioperative physician.

Advances in cancer treatments over the past decades combining chemotherapy with novel technologies in immunotherapies, radiation therapies, and interventional radiology have prolonged life expectancy. Patients have more options for treatments of their primary or metastatic diseases. Increased procedural techniques amid an aging population with multiple comorbidities present risks and challenges in the perioperative period.Chemotherapy remains the mainstay of cancer treatment, can be given intraoperatively, and is combined with other treatment modalities. Immunotherapy is particular to cancer c

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… These chronic changes arise over time and are most apparent in head and neck cancer patients — decreased range of motion, airway rigidity, and trismus. Difficult mask ventilation and laryngoscopy present considerable airway management challenges. …

Bridging the gap - Establishing a dental-oncology service in a cancer centre.

Dental disease remains the most common non-communicable disease worldwide. It predisposes patients to significant morbidities following bone modifying agents or radiation therapy to the head and neck. Preventative dental regimes effectively reduce the risk of both medication-related osteonecrosis of the jaw (MRONJ) and osteoradionecrosis (ORN) in these patients. Co-ordination of routine dental care as a component of mainstream oncology treatment optimises long term outcomes for oncology patients. This case series offers insights into patient, institutional and social difficulties that challeng

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… Operative difficulties included limited access due to trismus, extensive cancer-related intra and extraoral healing surgical sites and anti-coagulant considerations for the surgical removal of the lower wisdom tooth. …

Мелатонин за пределами хронобиологии: интеграция фармакокинетики, прогнозирование дозы и клинические данные.

Мелатонин установлен в качестве регулятора времени и сна в циркадиане, в то время как более широкий спектр зависящих от рецептора и независимых от рецептора биологических эффектов вызвал интерес к дополнительным видам терапевтического применения. В этом обзоре критически рассматривается вопрос о том, можно ли интерпретировать эти предлагаемые последствия в фармакологических рамках, основанных на воздействии. Мы интегрируем недавние доклинические и клинические данные с фармакокинетиками перорального и внутривенного мелатонина и с обычным дифференциальном уравнением (ОДВ) - прогнозом воздействия

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… Ruppel C, Rosa HH, Cardoso RB, Rigo NM, Soto VC, Bortoluzzi MC (2025) Preoperative 15 mg of melatonin for surgical discomfort, pain, edema and trismus in mandibular third molar surgery: a randomized double-blind placebo-controlled clinical trial. …

Immunotherapeutic approaches in EBV-associated nasopharyngeal carcinoma.

Epstein-Barr virus (EBV) was the first tumor virus in humans. Nasopharyngeal carcinoma (NPC) accounts for approximately 60% of the 200,000 new tumor cases caused by EBV infection worldwide each year. NPC has an insidious onset and is highly malignant, with more than 70% of patients having intermediate to advanced disease at the time of initial diagnosis, and is strongly implicated in epithelial cancers as well as malignant lymphoid and natural killer/T cell lymphomas. Over 90% of patients with confirmed undifferentiated NPC are infected with EBV. In recent decades, much progress has been made

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… Concurrent chemoradiotherapy is of great importance for improving treatment outcomes in locally advanced NPC but often leads to complications, such as xerostomia, trismus, and secondary tumors, which seriously impact patients’ quality of life ( 28 – 32 ). …

Characteristics and Components of Self-Management Interventions for Improving Quality of Life in Cancer Survivors: A Systematic Review.

Self-management can improve clinical and psychosocial outcomes in cancer survivors. Which intervention characteristics and components are beneficial is unclear, hindering implementation into practice. We systematically searched six databases from inception to 17 November 2021 for studies evaluating self-management interventions for adult cancer survivors post-treatment. Independent reviewers screened for eligibility. Data extraction included population and study characteristics, intervention characteristics (TIDieR) and components (PRISMS), (associations with) quality of life (QoL), self-effic

Более широкие соображения в отношении интеграции медицинских и стоматологических данных

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Comparison of oral chronic graft-versus-host disease characteristics between patients with malignant and non-malignant hematopoietic disorders.

ObjectivesTo characterize and compare the clinical manifestations of oral chronic graft-versus-host disease (cGVHD) in patients with malignant hematopoietic disorders versus those with non-malignant hematopoietic disorders, and to analyze associated risk factors.Materials and methodsDetailed examinations of the oral cavity were conducted in patients with malignant hematopoietic disorders (n = 52) and non-malignant hematopoietic disorders (n = 56) who developed oral cGVHD following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The severity of oral cGVHD was scored, and logisti

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… Additionally, other manifestations observed were mucosal blisters (13.33%), lingual and papillary atrophy (8.57%), oral hyperkeratosis (7.62%), cheilitis (7.62%), superficial mucous cysts (7.62%), and trismus (4.76%). …

Navigating Stomatologic Complications Secondary to Antineoplastic Agents-A Comprehensive Review.

This review systematically examines the oral complications associated with conventional and novel anti-cancer therapies. It highlights that while molecularly targeted agents including monoclonal antibodies targeting the vascular endothelial growth factor and its receptor, the epidermal growth factor receptor, tyrosine kinase inhibitors, and immune checkpoint inhibitors tend to exhibit a lower overall toxicity profile compared to traditional cytotoxic chemotherapeutics, they are nonetheless linked to significant oral adverse events. These complications encompass inflammatory mucosal reactions k

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… Pazopanib-induced trismus in a young male with metastatic renal cell carcinoma: A case report and literature review Oxford Med. Case Rep. 2024 2024 omad146 10.1093/omcr/omad146 PMC10823330 38292153 43. van Cann T. Loyson T. Verbiest A. Clement P.M. Bechter O. Willems L. Spriet I. Coropciuc R. …

The Bloody Crossroads: Interactions between Periodontitis and Hematologic Diseases.

Periodontitis is a common oral condition that can have a significant impact on the overall health of the body. In recent years, attention has been paid to potential relationships between periodontitis and various hematological disorders. This publication aims to present information available in the literature on this relationship, focusing on examples of red blood cell disorders (such as aplastic anemia and sickle cell anemia) and white blood cell disorders (such as cyclic neutropenia, maladaptive trained immunity, clonal hematopoiesis, leukemia, and multiple myeloma). Understanding these asso

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… Restricted Mouth Opening and Trismus in Oral Oncology. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2014;117:709–715. doi: 10.1016/j.oooo.2014.02.031. 98. Kuhlen M., Kunstreich M., Gökbuget N. Osteonecrosis in Adults With Acute Lymphoblastic Leukemia: An Unmet Clinical Need. …

Controlled Drug Delivery Systems for Oral Cancer Treatment-Current Status and Future Perspectives.

Oral squamous cell carcinoma (OSCC), which encompasses the oral cavity-derived malignancies, is a devastating disease causing substantial morbidity and mortality in both men and women. It is the most common subtype of the head and neck squamous cell carcinoma (HNSCC), which is ranked the sixth most common malignancy worldwide. Despite promising advancements in the conventional therapeutic approaches currently available for patients with oral cancer, many drawbacks are still to be addressed; surgical resection leads to permanent disfigurement, altered sense of self and debilitating physiologica

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… Side effects of radiation therapy due to transient or permanent damage to healthy tissues are fatigue, sore or dry mouth and difficulty swallowing, dental problems (tooth decay), taste change, loss of appetite, nausea and vomiting, nerve damage, pain, infection, osteoradionecrosis, trismus, lymphedema …

Post-traumatic growth and cancer survivorship: experiences of living with treatment-related impairment.

PurposeIncreased distress has been associated with impairment related to cancer treatment and with post-traumatic growth (PTG), but the influence of treatment-related impairment on PTG has not been explored. This study aimed to understand the lived experience of PTG for cancer survivors living with treatment-related impairment.MethodsHermeneutic phenomenology was used to develop a deep understanding of the lived experience of adult cancer survivors living with ongoing treatment-related impairment who had experienced self-perceived PTG following their cancer experience. Semi-structured individu

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… Impairments included peripheral neuropathy, infertility, osteonecrosis of the jaw, vision loss, dysphagia, trismus, xerostomia, and speech changes. Participants’ experiences of growth are depicted in a model comprising sequential themes (Fig. 1 ). …

A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments.

Gaucher disease (GD, ORPHA355) is a rare, autosomal recessive genetic disorder. It is caused by a deficiency of the lysosomal enzyme, glucocerebrosidase, which leads to an accumulation of its substrate, glucosylceramide, in macrophages. In the general population, its incidence is approximately 1/40,000 to 1/60,000 births, rising to 1/800 in Ashkenazi Jews. The main cause of the cytopenia, splenomegaly, hepatomegaly, and bone lesions associated with the disease is considered to be the infiltration of the bone marrow, spleen, and liver by Gaucher cells. Type-1 Gaucher disease, which affects the

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… These signs may be associated with trismus and hypertonia with pyramidal and possibly extrapyramidal rigidity [ 116 ]. Apnea related to increasingly frequent and lengthy laryngeal spasms occurs after a few months. …

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

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… Clinically, MRONJ manifests as persistent bone exposure accompanied by delayed wound healing, soft tissue inflammation, and, in advanced cases, the development of fistulas, pathological fractures, pain, paraesthesia, and trismus [ 4 ], [ 5 ], [ 6 ]. …

Inflammation, Fibrosis and Cancer: Mechanisms, Therapeutic Options and Challenges.

Uncontrolled inflammation is a salient factor in multiple chronic inflammatory diseases and cancers. In this review, we provided an in-depth analysis of the relationships and distinctions between uncontrolled inflammation, fibrosis and cancers, while emphasizing the challenges and opportunities of developing novel therapies for the treatment and/or management of these diseases. We described how drug delivery systems, combination therapy and the integration of tissue-targeted and/or pathways selective strategies could overcome the challenges of current agents for managing and/or treating chroni

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… For instance, radiation to the esophagus may result in strictures leading to decreased peristalsis [ 74 ], whereas patients with head and neck cancer treated with radiation therapy are at risk of developing trismus as a result of fibrosis and a contracture of mastication muscles which can impact the …

Neurology

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Diseases of the Nervous System

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Lysosomal storage diseases.

Lysosomes are cytoplasmic organelles that contain a variety of different hydrolases. A genetic deficiency in the enzymatic activity of one of these hydrolases will lead to the accumulation of the material meant for lysosomal degradation. Examples include glycogen in the case of Pompe disease, glycosaminoglycans in the case of the mucopolysaccharidoses, glycoproteins in the cases of the oligosaccharidoses, and sphingolipids in the cases of Niemann-Pick disease types A and B, Gaucher disease, Tay-Sachs disease, Krabbe disease, and metachromatic leukodystrophy. Sometimes, the lysosomal storage ca

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… Clinical manifestations include strabismus, oculomotor apraxia, trismus, dysphagia, retroflexion of the head, cortical thumbs and limb rigidity, increased deep tendon reflexes with a positive Babinski sign, pulmonary infections, and failure to thrive. Some patients have seizures. …