1/11. Avascular jaw osteonecrosis in association with cancer chemotherapy: series of 10 cases.BACKGROUND: We present a series of 10 patients with osteonecrosis of the jaws (ONJ) that appeared following cancer chemotherapy. MATERIAL AND methods: Of the 10 cases with ONJ, six had bone metastases from breast cancers and the other four had multiple myeloma. We analysed the location of bone metastases, as well as the characteristics of the ONJ, and the drugs with which they had been treated for their bone metastases. RESULTS: Of the 10 patients, all had ONJ in the mandible; 50% also had maxillary involvement. The average number of areas of painful exposed was 2.1 per patient (range 1-5). In seven patients a tooth extraction preceded the onset of ONJ. Two patients developed oroantral communications and another a cutaneous fistula to the neck with suppuration. In all the 10 patients the histopatholological diagnosis was of chronic osteomyelitis without evidence of metastatic disease to the jaws. All the patients had received treatment for their malignant bone disease with bisphosphonates. These were the only drugs that all patients had received. CONCLUSION: ONJ appears to have a relationship with the use of bisphosphonates.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/11. osteonecrosis of jaw in patient with hormone-refractory prostate cancer treated with zoledronic acid.Intravenous bisphosphonates are widely used in the management of metastatic bone disease, as well as osteoporosis. Recent published reports have documented a possible link between treatment with intravenous bisphosphonates and osteonecrosis of the jaw. We report a case of osteonecrosis of the jaw in 1 patient with prostate cancer receiving both chemotherapy and intravenous zoledronic acid (Zometa). Bisphosphonates have been demonstrated to alter the normal bone microenvironment and appear to have direct effects on tumors as well. These changes may contribute to the development of osteonecrosis of the jaw, particularly after tooth extractions or other invasive dental procedures.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/11. osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment.BACKGROUND/AIM: osteonecrosis of the jaws is being increasingly reported in patients with bone metastasis from a variety of solid tumours and disseminated multiple myeloma receiving intra-venous bisphosphonates. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue infection. A series of nine periodontally involving patients showing osteonecrosis of the jaws that appeared following the intra-venous use of bisphosphonates is reported. MATERIAL AND methods: Nine consecutive patients with osteonecrosis of the jaws were prospectically studied. patients' past medical histories and the drugs that they had received for their malignant disease were systematically documented. Clinical, histopathological and radiographic features and proposal for treatment modalities of osteonecrosis are also reported. RESULTS: Of the nine patients (six women and three men) observed, all had osteonecrosis in the mandible; two had maxillary involvement as well. All nine patients had a history of extraction of periodontally hopeless teeth preceding the onset of osteonecrosis. In two patients, the lesions also appeared in edentulous areas spontaneously. All the patients had received intra-venous bisphosphonates as treatment for their disseminated haematological neoplasms or metastatic bone disease. The duration of bisphosphonate therapy at presentation ranged from 10 to 70 months (median: 33 months). CONCLUSIONS: jaw osteonecrosis appears to be associated with the intra-venous use of bisphosphonates. Dental professionals should be aware of this potentially serious complication in periodontal patients receiving long-term treatment with bisphosphonates.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/11. The dental implications of bisphosphonates and bone disease.In 2002/2003 a number of patients presented to the South Australian Oral and Maxillofacial Surgery Unit with unusual non-healing extraction wounds of the jaws. All were middle-aged to elderly, medically compromised and on bisphosphonates for bone pathology. review of the literature showed similar cases being reported in the North American oral and maxillofacial surgery literature. This paper reviews the role of bisphosphonates in the management of bone disease. There were 2.3 million prescriptions for bisphosphonates in australia in 2003. This group of drugs is very useful in controlling bone pain and preventing pathologic fractures. However, in a small number of patients on bisphosphonates, intractable, painful, non-healing exposed bone occurs following dental extractions or denture irritation. Affected patients are usually, but not always, over 55 years, medically compromised and on the potent nitrogen containing bisphosphonates pamidronate (Aredia/Pamisol), alendronate (Fosamax) and zolendronate (Zometa) for non-osteoporotic bone disease. Currently, there is no simple, effective treatment and the painful exposed bone may persist for years. The main complications are marked weight loss from difficulty in eating and severe jaw and neck infections. Possible preventive and therapeutic strategies are presented although at this time there is no evidence of their effectiveness. dentists must ask about bisphosphonate usage for bone disease when recording medical histories and take appropriate actions to avoid the development of this debilitating condition in their patients.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
5/11. Bisphosphonate-induced avascular osteonecrosis of the jaws: a clinical report of 11 cases.Bisphosphonates are compounds used in the treatment of various metabolic and malignant bone diseases. In the last 2 years there has been a significant increase in referrals to the Department of Oral and Maxillofacial Surgery of patients with exposed necrotic jaw bone, diagnosed elsewhere as chronic refractory osteomyelitis of jaws, mostly after several teeth extractions. The only clinical feature in common for all the patients was the use of bisphosphonates in the treatment of bone diseases. A retrospective study was performed of 11 patients with necrotic bone lesions of the jaws of various extents referred to this Department from July 2003 to November 2004. The management of the patients included cessation of bisphosphonate therapy for 2-8 months and various surgical restorative procedures thereafter. Four patients (36%) presented with maxillary bone involvement, 6 (55%) had mandibular bone necrosis and 1 (9%) presented with necrosis at 3 quadrants. All patients had received bisphosphonate therapy for 6 months to 5 years. Biopsies from the necrotic lesions revealed no metastatic disease. One patient who was removed from bisphosphonate therapy for 8 months recovered completely, one other who was not removed from bisphosphonate therapy relapsed and for all the others, with cessation of bisphosphonate therapy for 2-6 months, the results were inconsistent. A new complication of bisphosphonate therapy administration, i.e. osteonecrosis of jaws, seems to be developing. The improved results after cessation of the medication should make clinicians reconsider the merits of the rampant use of bisphosphonates, while further investigation is needed to completely elucidate this complication.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/11. Hyaline ring granuloma: a distinct oral entity.Hyaline ring granuloma (HRG) is a distinct oral entity. In this study, 64 cases from the literature are analyzed and two new cases are reported. The lesions could be classified by location as central hyaline ring granuloma (42%) and peripheral hyaline ring granuloma (53%). Radiographically, a radiolucent area irregularly outlined by well-formed trabeculae of bone was found in central HRG, and a poorly defined erosion at the crest of the alveolar ridge was often found in peripheral HRG. Occasionally, the lesion occurred in the connective tissue wall of cysts (5%). The etiology of this condition is controversial, but most lesions were in edentulous areas and most patients had a history of tooth extraction or other trauma. The majority of cases (83%) occurred in the mandible, usually posterior to the premolar. The mean age of patients at diagnosis was 43 years, and the male/female ratio was 1.9:1. pain was not a symptom, although local discomfort, such as recurrent swelling and tenderness, was noted in many cases. Hyaline rings with giant cell inclusions are the significant features for histopathologic diagnosis. HRG is treated by curettage or surgical excision, care being taken to remove the entire lesion. The removal of a peripheral HRG in an edentulous jaw should be followed by careful smoothing of the bone surface, since the lesion tends to infiltrate and is not well demarcated. recurrence, probably due to incomplete excision, is uncommon.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/11. osteitis deformans. Report of a long-standing case with extensive oral involvement.Presented is a case of osteitis deformans (Paget's disease of bone) with a 38-year history after diagnosis. The patient had nearly the entire spectrum of symptoms that can result from widespread involvement of the skeletal system with this disease. Diffuse involvement of the maxilla and mandible resulted in postextraction complications which are common in Paget's disease of the bone.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/11. Etiology and treatment of idiopathic trigeminal and atypical facial neuralgias.In a series of sixteen patients with idiopathic trigeminal neuralgia and twenty-one patients with atypical facial neuralgia, it was found that the painful phenomena associated with both disorders were, in nearly all instances, closely related to the presence of maxillary or mandibular bone cavities at previous tooth extraction sites. Standard oral surgical procedures for curettage of the cavities, together with administration of antibiotics, were employed in the successful treatment of both the trigeminal and atypical facial neuralgias, with complete pain remissions for periods varying from 2 months (for most recently treated cases) up to 9 years. The observations and results of this study suggest that dental and oral disorders may play a role in the genesis of trigeminal and atypical facial neuralgias.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/11. fibrous dysplasia of bone and concomitant dysplastic changes in the dentin.fibrous dysplasia of bone and dentinal dysplasia have not been classified as related conditions. However, the present report describes a patient with both polyostotic fibrous dysplasia and dysplastic changes in the dentin. One bone lesion was first discovered on the right side of the mandible on a routine roentgenogram. There was an atypical radiolucency apical to a short-rooted molar with an obliterated pulp. Additional lesions were found on the left side of the mandible in the maxilla, in the frontal and occipital bones, in the ilium, in the proximal ulnae, and in the ribs. All lesions demonstrated an increased uptake of Tc99. A biopsy specimen of bone from the right side of the mandible showed small calcified islands in a cell-rich connective tissue. Microscopic analysis of the right first molar showed irregularly shaped dentin with the dentinal tubules arranged in a whorl-like fashion surrounding an almost completely obliterated pulp chamber and canal. Healing after tooth extraction and after the bone biopsy was unremarkable. After 6 months the alveolus was reorganized and the bone patterns appeared normal, although the radiolucent areas inferior to the teeth remained unchanged. The concomitant occurrence of dysplastic changes in bone and teeth may be a sign of a generalized defect in the mesenchymal hard-tissue-forming cells.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
10/11. Masticator space abscess complicating removal of suspension wires: case report.Masticator space abscesses have been reported more frequently in recent years. They are usually secondary to extractions of the first and second mandibular molar teeth. The use of antibiotics has changed the presentation and clinical course of these abscesses, masking the symptoms and resulting in secondary infection by resistant organisms. Therefore, selection of appropriate antibiotics is important, but surgical intervention remains the cornerstone of treatment. Suspension wires are being used widely in the treatment of midface fractures. These wires may extend from the zygomatic arch or frontal bone through the masticator space into the oral cavity to attach to arch bars. A case of masticator space abscess resulting from the removal of suspension wires is reported, and the relevant literature is reviewed. Suggestions are made for preventing and treating this complication.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
| | Next -> |