Bisphosphonate-related osteonecrosis of the jaw: the Florence experience

Borgioli, Alberto and Duvina, Marco and Brancato, Leila and Viviani, Christian and Brandi, Maria Luisa and Tonelli, Paolo (2007) Bisphosphonate-related osteonecrosis of the jaw: the Florence experience. Clinical cases in mineral and bone metabolism, 4 (1). pp. 48-52. ISSN 1971-3266

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Abstract

Aims. Bisphosphonates (BPs) are important therapeutic drugs in multiple myeloma and cancers with bone metastases. Bisphosphonate- Related Osteonecrosis of the Jaw (BRONJ) has been described as a potential side effect of the last generation BPs. The Authors evaluated clinical features, preventing measures and treatment strategies. Patients and methods. The Authors retrospectively analyzed 19 patients affected by malignant cancer in endovenous treatment with BPs. Fourteen patients were treated with zoledronate, 1 with pamidronate and 4 with both drugs for breast cancer (9 patients), multiple myeloma (6 patients), prostatic cancer (3 patients) and colon cancer (1 patient). Results. The lenght of therapy was 5-36 months before osteonecrosis was observed; in 15 patients BRONJ involved the mandible, in 2 the maxilla and in 2 both jaws. The trigger factors were tooth extractions, inadequate removable total denture, basic and advanced surgery, root canal treatment. Ten patients received non-surgical treatment, 7 patients minor surgical procedures and 2 patients a partial maxillectomy. Healing was achieved in all maxillary localization, and in one mandibular localization with partial maxillectomy. Conclusions. Prevention is the best important phase in the management of this pathology. Risk factors are the type of bisphosphonate and the length of exposure, while dental surgical procedures are trigger factors. Conservative treatment seems to be the best way to control BRONJ, but bone resection and soft tissue closure have to be performed when the lesion is refractory to conservative approach

Item Type:	Article
Uncontrolled Keywords:	bisphosphonates, osteonecrosis of the jaw, BRONJ
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 612 Fisiologia umana > 612.7 Sistema muscoloscheletrico, tegumento
Depositing User:	Danilo Dezzi
Date Deposited:	20 Jan 2014 10:19
Last Modified:	20 Jan 2014 10:19
URI:	http://eprints.bice.rm.cnr.it/id/eprint/4810

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