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Oral Surgical Management of Bone and Soft Tissues in MRONJ Treatment: A Decisional Tree.

BACKGROUND: The aim of the present work was to analyze a 10-year retrospective series of surgically treated medication-related osteonecrosis of the jaws (MRONJ) cases, reporting the clinical outcome and success rate for each adopted procedure in order to draw a treatment algorithm that is able to standardize clinical decision making and maximize the success of oral surgical treatment of MRONJ. METHODS: Different surgical approaches were categorized taking into consideration two variables a) hard tissue management (defined as debridement, saucerization or marginal resective surgery of maxillar

Реконструкция пашины фибулы для максимально вспомогательного этапа 3 Связанный с лекарствами остеонекроз челюсти с точки зрения получателей и доноров: предварительное исследование с использованием одного центра.

В то время как хирургическое лечение мантибулярной сцены 3 Остеонекроз челюсти (MRONJ), связанный с лекарственными препаратами, хорошо документирован, исследования на максимально вспомогательной стадии 3 MRONJ ограничен. Антирепрессивные препараты могут вызывать МРОНЮ и атипичный бедренный перелом (АФФ), однако их воздействие на возможность использования фибулы для восстановления по-прежнему вызывает споры. Цель этого исследования заключалась в оценке результатов хирургического вмешательства и функционального восстановления реконструкции пашины фибулы для максимальной вспомогательного этапа 3

Endodontics in Systemically Compromised Patients

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Comprehensive Review of Prevention and Management Strategies for Medication-related Osteonecrosis of the Jaw (MRONJ).

PURPOSE: To assess and classify the strategies employed in various dental specialities for the prevention and management of medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: A comprehensive literature review was conducted, acquiring studies sourced from Google Scholar and PubMed. The emphasis was on studies published in recent years, focusing on successful MRONJ prevention techniques across various dental specialties. RESULTS: Four types of prevention were identified. Primary prevention strategies include optimizing oral hygiene, managing dental caries, and extracti

Relationship between Drug Holidays of Antiresorptive Agents and Surgical Outcomes in Cancer Patients with Medication-Related Osteonecrosis of the Jaw.

It is controversial as to whether the withdrawal of antiresorptive (AR) agents is necessary while treating medication-related osteonecrosis of the jaw (MRONJ). In this study, we investigated whether a drug holiday promoted sequestrum separation and improved the surgical outcomes of MRONJ patients with malignant tumors, who were undergoing high-dose AR therapy. In total, we included 103 MRONJ patients with malignant tumors as their primary disease who underwent surgery at Nagasaki University Hospital or Kansai Medical University Hospital from January 2009 to December 2020. We recorded the patie

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… Osteolysis was classified as localized (the maxilla does not extend to the floor of the nasal cavity or the maxillary sinus floor, and the mandible extends above the mandibular canal) or extended (the maxilla extends to the floor of the nasal cavity or maxillary sinus floor, and the mandible includes … the lower mandibular canal). …

Oral squamous cell carcinoma vs. medication-related osteonecrosis of the jaw in patients assuming bone-modifying agents: a diagnostic challenge in a multi-hospital case series.

BACKGROUND: Despite advances in the diagnosis of oral squamous cell carcinoma (OSCC), most cases are diagnosed in advanced stages, influencing negatively the patient's prognosis. The absence of specific signs and symptoms contributes to the diagnostic delay of OSCC, often leading to confusion with various oral conditions, including, in patients with a history of bone modifying agents (BMA) and/or anti-angiogenic (AA) molecules, the Medication-Related Osteonecrosis of the Jaw (MRONJ). This study aims to investigate the characteristics of OSCC and MRONJ, focusing on clinical and radiological fea

SEDCYDO - SGER - SEMO ConГРЕСС МАДРИД 2025, 8-10 Возможно. Ход работы и резюме.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Prevalence of Free Flap Failure in Patients Undergoing Reconstruction for Medication-Related Osteonecrosis of the Jaw: A Systematic Review and Meta-Analysis.

Background/Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients treated with antiresorptive or antiangiogenic agents, particularly those with cancer-related comorbidities. This systematic review and meta-analysis aimed to estimate the prevalence of free flap failure in patients undergoing microvascular reconstruction for MRONJ. Methods: A comprehensive literature search was conducted across Medline/PubMed, Scopus, and Web of Science up to 30 January 2025. Inclusion criteria were observational studies involving MRONJ patients treated with free fl

Nitrogen containing bisphosphonates associated osteonecrosis of the jaws: A review for past 10 year literature.

Nitrogen containing bisphosphonate (N-BP) therapy is used extensively to treat osteoporosis and osteolytic bone lesions. Recently, a special form of osteonecrosis limited to the maxillofacial skeleton has been discovered especially within those patients who are receiving either long-term N-BP therapy alone and/or associated with invasive dental procedure. Bisphosphonates accumulate almost exclusively in maxillofacial skeleton owing to high bone turn over remodeling to maintain the mechanical competence. The pathogenesis and why it commonly appears in maxillofacial skeleton and the fixed treatm

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

Sclerotic bone: a sign of bone reaction in patients with medication related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction associated with antiresorptive drugs such as bisphosphonates and denosumab. When dealing with advanced and/or multiple MRONJ lesions undergoing surgical therapy, the extent of surgery is often a topic of discussion. The aim of this study was to identify the differences in bone density in and around the MRONJ lesion before and after surgical treatment to evaluate the needed surgical extend of the modelling osteotomy. In this retrospective study 26 patients with MRONJ lesions that were surgically treated in our dep

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… In addition osteolysis, mandibular canal enhancement, and bone sclerosis have already been described as typical findings of different MRONJ stages in panoramic radiograph 29 . …

Связанный с лекарствами остеонекроз челюсти у нескольких пациентов миэломы: серия случаев.

Остеонекроз челюсти (MRONJ), связанный с лекарственными препаратами, является осложнением антирепрессивной и антиангиогенной терапии, используемой при лечении злокачественных заболеваний, и может вызывать значительную функциональную и эстетичную заболеваемость у пациентов. Множественная миелома (ММ) — гематологическая порча плазмы и клеток, часто связанная с остеолитической болезнью костей. Антирезорптивная терапия (АРТ) уменьшает связанные со скелетом явления в MM и других магнатах с участием скелета, но связана с повышенным риском заболевания MRONJ. В настоящем документе представлены клиниче

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… OPG radiography was used for initial assessment and follow-up, and cone beam computed tomography (CBCT) or CT was employed when delineation of three-dimensional extent was required for staging, to assess association to the maxillary sinus or mandibular canal and to support surgical planning. 63 Systemic …

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.

Radiographic Patterns and Clinical Correlates of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Retrospective Analysis.

Objectives: This study aimed to evaluate the radiographic characteristics of medication-related osteonecrosis of the jaw (MRONJ) by digital panoramic radiographs and to investigate the associations between radiographic findings and clinical, demographic, and treatment-related variables in patients receiving antiresorptive therapy. Methods: A retrospective analysis was performed on 55 patients receiving antiresorptive therapy, categorized into a tooth-extraction group (n = 20) and an MRONJ group (n = 35). Standardized panoramic radiographs obtained at baseline (T0) and during the 6-month follow

APPLICATION OF ANTERIOR MINI-INCISION VERTEBROPLASTY IN CERVICAL METASTASES.

OBJECTIVE: To investigate the efficacy and safety of anterior cervical mini-incision vertebroplasty in the treatment of vertebral metastases. METHODS: From July 2009 to March 2013, seven cases of vertebral metastases were treated by using vertebroplasty through an anterior cervical paratracheal mini-incision guided by C-arm X-ray in Beijing friendship hospital, Capital medical university. Among them, three were male and four were female, aged 51 to 74 years with an average age of 61.7 years. Preoperative and postoperative Visual Analog Scale (VAS) scores and analgesic medication usage were ev

Борьба с травматической деформацией подбородка на чехле в недавно диагностированном миеломе: пример.

Обычно фонопатенты с множественной миеломой (ММ) управляются многодисциплинарными командами по онкологии в соответствии с неврологической, онкологической, механической и систематической системой принятия решений. Хирургия указывается на механическую нестабильность и/или неврологические недостатки. В неврологических и механически стабильных пациентах химиотерапия и радиотерапия часто являются основным лечением. 66-year-old Пациент мужского пола получил кифотическое повреждение подбородка на чехле из-за недиагностированной спинной мышцы ММ. Он испытывал постепенную боль в шее и трудности в повсе

A retrospective study on the incidence of medication-related osteonecrosis of the jaws (MRONJ) associated with different preventive dental care modalities.

PURPOSE: To assess the efficacy of different preventive dental visits and treatments in reducing the risk of medication-related osteonecrosis of the jaws (MRONJ). METHODS: In this retrospective study, patients diagnosed with MRONJ were divided into 5 groups based on available data: no preventive dental visits (group 0); dental visits and compliance with recommended treatments, at the university hospital's dental clinic (group 1) or maxillofacial surgery unit (group 2), or at a private dentist's (group 3); dental visits at one of the above and noncompliance with proposed treatments (group 4);

Management of Medication-Related Osteonecrosis of the Jaws With Hyperbaric Oxygen Therapy: A Case Report.

Medication-related osteonecrosis of the jaw (MRONJ) refers to the condition where the maxillary or mandibular bone becomes exposed and necrotic as a result of bisphosphonate therapy. The number of patients on bisphosphonates is increasing and so are the MRONJ cases. Since the initial data were published in the early 2000s, research into MRONJ has expanded significantly to enhance the understanding of this emerging condition. Various treatment options are available, but none have been established as the definitive "gold standard" for managing this disease. Hyperbaric oxygen therapy (HOT) is one

Are medication-induced salivary changes the culprit of osteonecrosis of the jaw? A systematic review.

PURPOSE: This systematic review was performed to assess the potential influence of medication-induced salivary changes on the development of medication-related osteonecrosis of the jaw (MRONJ). METHODS: An electronic search was conducted using PubMed, Web of Science, Cochrane, and Embase databases for articles published up to June 2023. A risk of bias assessment was performed according to the modified Newcastle-Ottawa Scale (NOS). Due to the heterogeneity of the selected studies in relation to the type of medications and outcomes evaluated, a meta-analysis could not be performed. RESULTS: Th

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… The early imaging signs of MRONJ include bone sclerosis, lamina dura thickening, alveolar socket persistence following tooth extraction, periapical radiolucency, robust mandibular cortex, expanded periodontal ligament space, receding periodontal bone, and an expanded mandibular canal ( 7 – 9 ). …

Oral health, dental treatment, and medication related osteonecrosis of the jaw in multiple myeloma - a longitudinal cohort study.

OBJECTIVE: The objective of the present study was to investigate oral health status, oral health related quality of life, and identify risk factors associated with invasive dental treatment and medication related osteonecrosis of the jaw in patients with multiple myeloma. MATERIAL AND METHODS: Patients newly diagnosed with multiple myeloma (n = 144) referred between January 2015 and September 2022 were retrospectively included. The patients underwent a thorough clinical and radiological oral examination and odontogenic infections were treated before the start of bisphosphonate treatment. The