The literature describes an increasing presence of bisphosphonate-induced osteonecrosis of the jaws (ONJ), characterized by the exposure for over 8 weeks of necrotic bone in the maxillofacial region, after bisphosphonate therapy, in the absence of prior maxillary radiotherapy. The present literature review examines the etiopathogenesis, risk factors, clinical forms, diagnosis, treatment and prevention of bisphosphonate-induced ONJ. In addition, a review is made of all the series involving over 15 patients diagnosed with this disorder between 1 January 2011 and 15 May 2011. A PubMed-Medline search was carried out with the following key words: "bisphosphonates" and "osteonecrosis". The appearance of osteonecrosis is a serious complication, with an increasing incidence, that affects patient quality of life and causes important morbidity. All patients treated with bisphosphonates are at risk of developing osteonecrosis as a result of such medication. This potential complication therefore should be explained to the patient by both the prescribing physician and the dental surgeon in charge of oral treatment, with the obtainment of informed consent in all cases. Key words:Osteonecrosis of the jaws, bisphosphonates, etiopathogenesis, prevention, treatment.
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http://dx.doi.org/10.4317/jced.50649 | DOI Listing |
J Bone Oncol
February 2025
Unit of Oral Medicine and Dentistry for Frail Patients, Department of Rehabilitation, Fragility, and Continuity of Care, Regional Center for Research and Care of MRONJ, University Hospital Palermo, Palermo, PA, Italy.
Background: Low-doses of bone modifying agents (LD-BMAs) compared to those used to treat bone metastases are used in breast or prostate cancer patients on adjuvant endocrine therapy to prevent Cancer Treatment Induced Bone Loss (CTIBL). Their use is associated with an increased risk of developing Medication-Related Osteonecrosis of the Jaw (MRONJ). However, there is not clarity about strategies aimed to minimize the MRONJ risk in cancer patients at different conditions as low- vs high-doses of BMA.
View Article and Find Full Text PDFMed Devices (Auckl)
January 2025
Department of Implantology, Clinic for Integrative Dentistry, Munich, 81547, Germany.
Despite the widespread use of ultrasonography (US) in medical diagnostics, there is no similar US device available for visualizing jawbone density. This study is a narrative review of the possible applications of US in dentistry. This review is divided as follows: (a) Pulse-echo ultrasonography: the applications offer new perspectives for periodontal and peri-implant assessment.
View Article and Find Full Text PDFEndocrinol Metab (Seoul)
January 2025
Division of Endocrinology & Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Osteoporosis management in post-menopausal women focuses on fracture prevention, with denosumab as a key therapeutic option. Despite its proven efficacy in reducing fracture risk and increasing bone mineral density (BMD) over 10 years, its long-term impact remains uncertain. We evaluated the literature on its efficacy and safety beyond the initial decade.
View Article and Find Full Text PDFJ Craniomaxillofac Surg
January 2025
Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
The potential of large language models (LLMs) in medical applications is significant, and Retrieval-augmented generation (RAG) can address the weaknesses of these models in terms of data transparency and scientific accuracy by incorporating current scientific knowledge into responses. In this study, RAG and GPT-4 by OpenAI were applied to develop GuideGPT, a context aware chatbot integrated with a knowledge database from 449 scientific publications designed to provide answers on the prevention, diagnosis, and treatment of medication-related osteonecrosis of the jaw (MRONJ). A comparison was made with a generic LLM ("PureGPT") across 30 MRONJ-related questions.
View Article and Find Full Text PDFOral Dis
January 2025
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Objectives: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe complication of bisphosphonate therapy, with unclear mechanisms. This study investigates the regulatory impact of zoledronic acid (ZOL) on osteoclasts and microRNA (miRNA) expression.
Materials And Methods: Raw264.
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