Objective: To describe the clinical characteristics and evolution of our series of medication-related osteonecrosis of the jaws (MRONJ) associated with denosumab in osteoporotic patients.
Material And Methods: We present 10 new cases of MRONJ in patients receiving denosumab for osteoporosis. We describe the mean doses of denosumab, previous bisphosphonate intake, and the clinical characteristics associated with the osteonecrosis, such as local contributing factors, symptoms, and evolution after treatment.
Results: The mean number of denosumab doses was 3.4 ± 2.2. In 90% of patients, there was a prior history of oral bisphosphonate intake, with a mean duration of 46.78 ± 25.11 months. The most common local factor was dental extraction (6 cases; 60%), and most cases had necrotic bone exposure (9/10, 90%). Sclerosis of the bone was the most common radiographic finding. Stage 1 was the most common ONM stage, found in 80%. 'Cure' after conservative treatments was obtained in 71.4%.
Conclusions: Most of our cases were in the early stages of MRONJ, and the success rate after conservative treatment was high.
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http://dx.doi.org/10.1111/odi.12447 | DOI Listing |
Cells
January 2025
Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, University of Pecs, 7624 Pecs, Hungary.
Maxillofacial bone defects can have a profound impact on both facial function and aesthetics. While various biomaterial scaffolds have shown promise in addressing these challenges, regenerating bone in this region remains complex due to its irregular shape, intricate structure, and differing cellular origins compared to other bones in the human body. Moreover, the significant and variable mechanical loads placed on the maxillofacial bones add further complexity, especially in cases of difficult-to-treat medical conditions.
View Article and Find Full Text PDFBMC Oral Health
January 2025
Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173 beon-gil, Bundang-gu, Bundang‑gu, 13620, Seongnam, Republic of Korea.
Background: This study aims to evaluate the clinical outcome of biofluorescent imaging system (BIS) guided MRONJ surgery through analyzing 3D volumetric changes in CBCT data of bone structure.
Methods: BIS-guided surgery for MRONJ surgery was performed by grinding red-fluorescent area from remained residual bone detected by Qray-pen. CBCT data was collected preoperatively, postoperatively, and at last follow-up more than 3 months of each patient.
Front Bioeng Biotechnol
January 2025
State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
Objectives: Platelet concentrates (PCs), which are blood products that are abundant in platelets and growth factors, have become pivotal in treating maxillofacial tissue lesions due to their capacity for promoting bone and soft tissue recovery. This review will provide some recent progress of the use of platelet concentrates to treat lesions on maxillofacial tissues.
Subjects: We reviewed the mechanisms by which PCs promote wound healing and tissue recovery and summarized the application of PCs in the treatment of lesions on maxillofacial tissues, including medication-related osteonecrosis of the jaw, post-extraction wound healing, implant surgery, temporomandibular joint diseases, and periodontal tissue restoration.
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 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.
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