1/16. Unhealed extraction sites mimicking TMJ pain.A case of unhealed extraction sites in the mandible is described, including clinical, radiographic, and biopsy findings. The subject was treated for TMJ disease in the past but still had related signs and symptoms and facial pain.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/16. Localized alveolar bone necrosis following the use of an arsenical paste: a case report.AIM: To describe some toxic effects of arsenic trioxide in the mouth, to condemn its continued use, and present a case in which a tooth was preserved despite significant bony destruction. SUMMARY: A case is presented in which severe alveolar bone necrosis resulted from leak-age of an arsenical devitalization paste into the periodontium.The tooth was root canal treated before root amputation, and restored with a cuspal coverage restoration. The tooth was observed to be symptomless and functional at the one-year follow-up. KEY learning POINTS: * arsenic and its compounds have no place in contemporary endodontics. * dentists should protect their patients by avoiding the use of arsenic-containing materials and refusing to use products whose constituents are not known. * Localized bone necrosis may not require tooth extraction. Depending on the severity of the case, the tooth may be preserved by a combination of endodontic, periodontal,prosthodontic and maintenance therapies.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
3/16. 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 = 0.2keywords = extraction (Clic here for more details about this article) |
4/16. Extensive maxillary sequestration resulting from mucormycosis.mucormycosis is an invasive and potentially lethal infection caused primarily by fungi of the order mucorales. An ulcer or extraction in the mouth can be the port of fungal invasion, particularly when the patient is immunocompromised. Early recognition and aggressive treatment have reduced the mortality and morbidity. We present a case of oral mucormycosis with extensive maxillary osteonecrosis that is of interest because the patient ignored the initial warning signs and was rescued from the fulminating stage by thorough debridement and medical treatment.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
5/16. 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 = 0.2keywords = extraction (Clic here for more details about this article) |
6/16. jaw bone necrosis without previous dental extractions associated with the use of bisphosphonates (pamidronate and zoledronate): a four-case report.jaw bone necrosis is a clinical condition associated with defects in vascularization of the maxilla or the mandibular bone, usually present following head and neck radiotherapy and/or oral surgical interventions. Bisphosphonates are synthetic analogues of pyrophosphate used in the treatment of patients with hypercalcemia as a result of malignancy, bone metastasis and for the treatment of other disorders such as metabolic bone diseases, Paget's disease and osteoporosis. Over last 10 years, cases of jaw bone necrosis have been associated with the use of bisphosphonate therapy. In particular, Ruggiero et al. (J Oral Maxillofac Surg 2004; 62: 527-534) in 2004 described a large group of patients (63) with jaw bone necrosis probably related to the use of these drugs. It should be noted that all the patients in the group described either underwent head and neck radiotherapy or had a dental extraction while taking bisphosphonates. In the present study, we reported four cases of jawbone necrosis in patients taking pamidronate (Aredia) and zoledronate (Zometa) without having undergone any kind of radiotherapy or dental surgery. All the patients were females between the ages of 56 and 71 years; three were treated with bisphosphonates for bone metastasis and one for multiple myeloma. All the patients received surgical treatment with bone curettage, with partial and/or temporary improvement of the lesions. Although a treatment for bisphosphonate-induced bone lesions has not yet been established, we suggest careful evaluation of the patients' oral health before prescribing bisphosphonate treatment.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/16. 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 = 0.2keywords = extraction (Clic here for more details about this article) |
8/16. Endodontic implications of bisphosphonate-associated osteonecrosis of the jaws: a report of three cases.Bisphosphonates are commonly used in medicine to maintain bone density in patients with certain nonneoplastic diseases or cancers. A serious adverse effect of bisphosphonates that has substantial dental significance is osteonecrosis that appears to uniquely affect the mandible and maxilla without occurring in other bones of the skeleton. patients with bisphosphonate associated osteonecrosis of the jaws may present with pain and exposed necrotic bone. This has substantial clinical implications because surgical procedures (including extractions or endodontic surgical procedures) are contraindicated in the jaws of these patients and the presenting pain may mimic pain of odontogenic origin. This report describes three patients with bisphosphonate associated osteonecrosis and emphasizes the endodontic implications of managing these patients.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
9/16. 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 = 0.4keywords = extraction (Clic here for more details about this article) |
10/16. association of osteonecrosis of the jaws and bisphosphonate pharmacotherapy: dental implications.Bisphosphonates are drugs of choice in the management of a variety of bone disorders including osteoporosis, Paget's disease and bone cancer. Recently there have been increasing reports of a possible relationship between bisphosphonate therapy and osteonecrosis of the jaws. osteonecrosis may occur following extractions or dental surgery and, in some cases, may appear spontaneously. Because of the potentially serious nature of these complications and the failure of exposed bone to heal, dentists must be aware of recommended precautions for the management of patients taking bisphosphonate medication.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
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