CASE REPORTPrimary Surgical Therapy for Osteonecrosis of the Jaw Secondary to Bisphosphonate Therapy
Section snippets
Case 1
A 73-year-old man was referred from the hematology service at the Mayo Clinic in Rochester, Minn, to the Division of Oral and Maxillofacial Surgery for evaluation of bone exposure and pain in the right posterior mandibular alveolus. The patient's primary disease process was multiple myeloma, for which he had undergone stem cell transplantation in March 2003 and subsequent systemic BPT with zoledronate (Zometa, Novartis, East Hanover, NJ). In March 2005, he consulted his local general dental
DISCUSSION
Considerable speculation has centered on the mechanisms of ONJ development in individuals receiving BPT. Three principal theories of etiology have been offered: (1) bisphosphonates inhibit osteoclast activity, thereby reducing the rate of bone turnover, which results in compromised bone wound healing; (2) bone healing is compromised, but the lack of primary mucosal closure over areas of exposed bone is the key factor in the development of ONJ; and (3) bone healing is compromised, but factors
REFERENCES (11)
Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic [letter]
J Oral Maxillofac Surg
(2003)- et al.
Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment
J Oral Maxillofac Surg
(2005) Bisphosphonates and bone necrosis [letter]
J Oral Maxillofac Surg
(2004)- et al.
Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases
J Oral Maxillofac Surg
(2004) - et al.
Jaw avascular bone necrosis associated with long-term use of bisphosphonates [letter]
Ann Oncol
(2005 Jul)
Cited by (74)
'Til Poison Phosphorous Brought them Death': A potentially occupationally-related disease in a post-medieval skeleton from north-east England.
2016, International Journal of PaleopathologyCitation Excerpt :This has parallels with the occurrence of osteochemonecrosis of the upper and lower jaws caused by the use of bisphosphonates for treating cancer metastases and osteoporosis today (Ardine et al., 2006; Campisi et al., 2012). Indeed, osteochemonecrosis has been likened to “phossy jaw” of the 19th and 20th centuries, and since 2003 a number of people have been recorded clinically with this jaw problem (Marx, 2003, 2008; Khamaisi et al., 2007). These drugs inhibit bone metabolism (Otto et al., 2011), for example, acting as an anti-resorption/osteoclast inhibitor drug to prevent fractures in osteoporosis and Paget’s disease (Abu-Id et al., 2008), and animal experiments have shown that orally administered white phosphorus also suppresses bone destruction (Abu-Id et al., 2008).
Surgical Therapy for Bisphosphonate-Related Osteonecrosis of the Jaw: Six-Year Experience of a Single Institution
2015, Journal of Oral and Maxillofacial SurgeryMandibular inferior cortical bone thickness on panoramic radiographs in patients using bisphosphonates
2015, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyMultiple Myeloma and Related Disorders
2014, Abeloff's Clinical Oncology: Fifth EditionAmerican association of oral and maxillofacial surgeons position paper on medication-related osteonecrosis of the jaw - 2014 update
2014, Journal of Oral and Maxillofacial Surgery