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A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders
Published on: June 8, 2014
[Jaw osteonecrosis induced by oral biphosphonates: 12 cases]
A Barrier1, G Lescaille, A Rigolet
1Service de stomatologie et chirurgie maxillofaciale, hôpital Saint-Louis, Paris, France.
Revue De Stomatologie Et De Chirurgie Maxillo-Faciale
|September 3, 2010
Summary
Jaw osteonecrosis from bisphosphonates (BP) is increasing. Tooth extraction often triggers this condition, but management leads to favorable outcomes for most patients with BP-related osteonecrosis of the jaw.
Area of Science:
- Oral and Maxillofacial Surgery
- Pharmacology
- Oncology
Background:
- Bisphosphonates (BP) are increasingly associated with medication-related osteonecrosis of the jaw (MRONJ).
- Previous reports indicate a rising incidence of BP-induced jaw osteonecrosis.
- This study details 12 cases of oral BP-induced osteonecrosis of the jaw (JONOBP).
Purpose of the Study:
- To analyze clinical characteristics and management of JONOBP.
- To identify risk factors and outcomes in patients with JONOBP.
- To evaluate treatment strategies and patient evolution.
Main Methods:
- A pluridisciplinary team managed 12 patients with JONOBP from January 2007 to January 2009.
- Data collected included patient demographics, BP details, comorbidities, triggering factors, and treatment.
- Clinical, radiological, and pathological findings were documented using AAOMS classification.
Main Results:
- The study included 10 women and 2 men (mean age 65), with mean BP exposure of 39.6 months.
- Tooth extraction was the primary trigger in 9 cases; mandibular premolar/molar areas were most affected.
- Alendronate and risedronate were most implicated; 9 patients underwent surgery with favorable evolution for 9, and 6 achieved cure.
Conclusions:
- Longer BP exposure (>3 years) and tooth extraction are key factors in JONOBP development.
- Higher comorbidity, especially corticosteroid use, correlated with more advanced stages (AAOMS Stage 2 & 3).
- Management aligned with Afssaps and AAOMS guidelines resulted in favorable outcomes for all treated patients.
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