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Medication-related osteonecrosis of the jaw is an oral complication in cancer patients being treated with either antiresorptive or antiangiogenic drugs. The first reports of MRONJ were published in 2003. Hundreds of manuscripts have been published in the medical and dental literature describing the complication, clinical and radiographic signs and symptoms, possible pathophysiology, and management. Despite this extensive literature, the pathobiological mechanisms by which medication-related osteonecrosis of...
To provide guidance regarding best practices in the prevention and management of medication-related osteonecrosis of the jaw (MRONJ) in patients with cancer.
Osteonecrosis of the jaw is a potential side effect of certain pharmaceutical agents used in the field of medicine. Early diagnosis and effective management of this condition can be challenging to the clinicians. Bisphosphonates and other anti-angiogenic agents are the most common drugs that are attributed to cause medication-related osteonecrosis of the jaw. In the past, arsenic-based compounds were commonly used local agents for pulp devitalization therapy. Arsenic is also one of the components of the che...
We examined the effect of the membranous form of platelet-rich fibrin (PRF) on patients with medication-related osteonecrosis of the jaw.
The aim of this study was to assess a three-dimensional (3D) correlation between preoperative 3D bone SPECT/CT, which allows the visualization of radiotracer uptake on 3D volume-rendered CT images, and histopathological characteristics in the medication-related osteonecrosis of the jaw (MRONJ).
This study characterized histologic features of medication-related osteonecrosis of the jaw (MRONJ) through analysis of tissues from patients and healthy individuals.
Medication-Related Osteonecrosis of the Jaws (MRONJ) incidence are increasing among elderly. Treatment can be challenging. Prevent or treatment protocols that control evolution of the lesion are warranted.
Medication-related osteonecrosis of the jaw in its advanced stages requires surgical treatment to resolve the pathology and to achieve good long-term results. After complete removal of the necrotic bone and infected soft tissue, it is essential to cover the exposed bone using well-vascularized soft tissue such as local, regional, and microvascular free flaps. The purpose of this study was to evaluate the technical usefulness of the modified submental island flap (SIF) for covering large bone and soft tissue...
The pathophysiology of medication-related osteonecrosis of the jaw (MRONJ) is associated with microcirculatory dysfunction, direct toxicity to osteoblast, osteoclast and bone marrow stromal cells (BMSCs), bacterial infection, related factors, immune dysfunction, and transforming growth factor-beta (TGF-β1) pathway. MRONJ and osteoradionecrosis of the jaw (ORN) shared some histological characteristics, suggesting that improving blood flow, increasing blood supply to the lesion and regulating TGF-β1/BMP sig...
To establish the profile of patients who developed antiangiogenic agent-related osteonecrosis of the jaws, and identify the treatments currently used in dental management. We searched the PubMed®/Medline® and Scopus databases using the words "osteonecrosis AND antiangiogenic therapy", with the following inclusion criteria: articles published in English, case reports, available online, and for an unlimited period. Of the 209 articles retrieved, 18 were selected, for a total of 19 case reports, since one ar...
Patellar osteonecrosis is a rare condition, although knee osteonecrosis has been described in the arthroplasty literature. This is the first case describing knee arthroscopy as the cause of osteonecrosis. A 50-year-old woman who was experiencing knee pain during her marathon training and singles tennis underwent knee arthroscopy for a torn medial meniscus. The result of her partial medial meniscectomy led to patellar osteonecrosis 3 months following the index procedure. Osteonecrosis of the knee has been re...
This paper reports on the conclusions of two workshops held in Copenhagen in September 2017 and November 2018 focused on medication-related osteonecrosis of the jaws (MRONJ). The workshops were organized and attended by a European task force on MRONJ, i.e. a multidisciplinary group of European clinical investigators with a special interest in the diagnosis and management of MRONJ and a track record of relevant research and publications. The aim of the workshops were to (i) highlight some of the most controv...
Rituximab, an anti-CD20 monoclonal antibody, is an effective treatment for rheumatoid arthritis. Here we report the case of a patient with rheumatoid arthritis, having taken risedronate for 14 months to prevent corticosteroid-induced osteoporosis, more than 2 years ago, who presented osteonecrosis of jaw following herpetic gingivostomatitis two weeks after the beginning of a rituximab treatment associated with her usual antirheumatic drugs. Eight weeks later, no bone and/or gum healing was observed and a st...
To explore medication safety issues related to use of an electronic medication management system (EMM) in paediatric oncology practice, through the analysis of patient safety incident reports.
The purpose of this study was to evaluate potential differences in volumes of areas of osteolysis caused by medication-related osteonecrosis of the jaw (MRONJ) between the upper and lower jaw. We aim to analyze the clinical relevance of volumetric measurement of osteolytic lesions for surgical planning of MRONJ patients.
Evidence-based approaches for the treatment of opioid use disorder include the use of opioid medications (methadone, buprenorphine, or naltrexone), collectively referred to as medication-assisted therapy. Patients receiving medication-assisted therapy may present in the acute care setting with pain, often related to planned surgical procedures to treat health issues that were not addressed before entering treatment. Because these medications act on the same receptors as do analgesic opioids-and, in the case...
Bisphosphonates (BP) have long been used for treatment of osteoporosis and diseases like bone malignancies, active Paget disease of bone, severe osteogenesis imperfecta, and fibrous dysplasia among others. They bond highly to the bone surface and inhibit bone resorption. As bisphosphonates have a long half-life in bone because of their irreversible binding to bone, patients retain their risk profile even after drug cessation. This property also explains the complications wherein the cessation of bone resorp...
Ageing in place raises pressing questions about medication practices at home. Understanding how medication practices are integrated into older adults' domestic settings requires an interest in where activities linked to medication take place and why. This study aimed to describe the medication practices and spatial dimensions of medication management for home-dwelling older adults after hospital discharge, using a qualitative research design. Semi-structured interviews were carried out with ten older adults...
Surgical specimen management is an important responsibility of perioperative nurses and is essential to the provision of safe, quality patient care. Errors related to surgical specimen management can lead to a variety of negative consequences for patients and personnel. Unfortunately, surgical specimen management errors can and do occur, particularly during the preanalytic phase, and thus are a major perioperative patient safety concern. The overall management process for various surgical specimens is essen...
To investigate the effect and underlying mechanism of Yougui pills (YGPs) on steroid-related osteonecrosis of the femoral head (SONFH).
Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication that can develop in patients treated with anti-resorptive drugs. Although the pathogenesis of MRONJ is still unclear, genetic factors have a demonstrated important role. Thus, the aim of this study was to perform a systematic review on the pharmacogenetics of MRONJ. Studies published until March 2019 were retrieved from eight databases and were selected by two independent reviewers. Evidence on several genetic polymorphisms was sum...
To investigate nurses' experiences with implementation of knowledge gained through an obligatory medication management program (MMP).