Clinical profile of individuals with bisphosphonate-related osteonecrosis of the jaw
an integrative review
Palavras-chave:
Osteonecrosis, Jaw, Diphosphonates, Bisphosphonate-associated osteonecrosis of the jaw, Dental care, Angiogenesis inhibitorsResumo
BACKGROUND: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is still the most prevalent type of osteonecrosis with clinical relevance. In Brazil, bisphosphonate use is high but there is a lack of epidemiological studies on BRONJ. OBJECTIVE: To determine the clinical profile of BRONJ in a Brazilian population through an integrative review. DESIGN AND SETTING: Integrative review of BRONJ in a Brazilian population. METHODS: Cases and clinical research on Brazilians with BRONJ between 2010 and 2019, indexed in PubMed/MEDLINE, Scopus, Web of Science and LILACS were reviewed. Age, sex, type and time of bisphosphonate intake, administration route, related diseases, region of the BRONJ, diagnostic criteria, staging, triggering factor and type of treatment were analyzed. RESULTS: Fifteen articles on 128 subjects were included. Most patients were women (82.03%); the mean age was 63 years. Intravenous zoledronic acid was mostly used (62.50%), for breast cancer treatment (46.87%). The main localization of BRONJ was the mandible (54.68%), associated mainly with tooth extractions (45.98%). The diagnostic criteria were clinical (100%) and radiographic (89.06%), mostly in stage II (68.08%). The surgical treatments were sequestrectomy (37.50%) and platelet-rich plasma (PRP) (36.71%). Microbial control was done using chlorhexidine (93.75%) and infection control using clindamycin (53.90%). CONCLUSIONS: BRONJ had higher prevalence in Brazilian women receiving treatment for breast cancer and osteoporosis. The mandible was the region most affected with a moderate stage of BRONJ, particularly when there were histories of tooth extraction and peri-implant surgery. Sequestrectomy with additional drugs and surgical therapy was the treatment most accomplished.
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Drake MT, Clarke BL, Khosla SM. Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc. 2008;83(9):1032-45. PMID: 18775204; doi: 10.4065/83.9.1032.
Duarte LF, Alonso K, Basso EC, Dib LL. Surgical treatment of bisphosphonate-related osteonecrosis of the jaws with the use of buccal fat pad: case report. Braz Dent J. 2015;26(3):317-20. PMID: 26200161; doi: 10.1590/0103-6440201301918.
Miniello TG, Araújo JP, Lopes RN, Alves FA. Osteonecrosis related to once-yearly zoledronic acid treatment in an osteoporotic patient after dental implant. Braz Dent J. 2015;26(1):86-8. PMID: 25672391; doi: 10.1590/0103-6440201300255.
Conte-Neto N, Bastos AS, Spolidorio LC, Marcantonio RA, Marcantonio E Jr. Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports. Head Face Med. 2011;7:7. PMID: 21524309; doi: 10.1186/1746-160X-7-7.
Zanata A, Felin GC, De Bona MC, Sawazaki R, De Conto F. Osteonecrose mandibular associada ao uso de bisfosfonato de sódio em paciente com mieloma múltiplo [Bisphosphonate-related osteonecrosis of the jaw in patient affected by multiple myeloma: A case report]. Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial. 2014;55(2):115-20. doi: 10.1016/j.rpemd.2014.04.002.
Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61(9):1115-7. PMID: 12966493; doi: 10.1016/S0278-2391(03)00720-1.
Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg. 2004;62(5):527-34. PMID: 15122554; doi: 10.1016/j.joms.2004.02.004.
Ruggiero SL, Dodson TB, Fantasia J, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg. 2014;72(10):1938-56. PMID: 25234529; doi: 10.1016/j.joms.2014.04.031.
Curi MM, Cossolin GS, Koga DH, et al. Bisphosphonate-related osteonecrosis of the jaws--an initial case series report of treatment combining partial bone resection and autologous platelet-rich plasma. J Oral Maxillofac Surg. 2011;69(9):2465-72. PMID: 21763050; doi: 10.1016/j.joms.2011.02.078.
Lopes RN, Rabelo GD, Rocha AC, Carvalho PA, Alves FA. Surgical Therapy for Bisphosphonate-Related Osteonecrosis of the Jaw: Six-Year Experience of a Single Institution. J Oral Maxillofac Surg. 2015;73(7):1288-95. PMID: 25871903; doi: 10.1016/j.joms.2015.01.008.
Sverzurt CE, Sverzurt AT, de Matos FP, et al. Mandibular bisphosphonate-related osteonecrosis after dental implant rehabilitation: a case report. Implant Dent. 2012;21(6):449-53. PMID: 23075811; doi: 10.1097/ID.0b013e3182703c4f.
Maluf G, Pinho MC, Cunha SR, Santos PS, Fregnani ER. Surgery Combined with LPRF in Denosumab Osteonecrosis of the Jaw: Case Report. Braz Dent J. 2016;27(3):353-8. PMID: 27224573; doi: 10.1590/0103-6440201600662.
Malan J, Ettinger K, Naumann E, Beirne OR. The relationship of denosumab pharmacology and osteonecrosis of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(6):671-6. PMID: 23159111; doi: 10.1016/j.oooo.2012.08.439.
Fusco V, Santini D, Armento G, Tonini G, Campisi G. Osteonecrosis of jaw beyond antiresorptive (bone-targeted) agents: new horizons in oncology. Expert Opin Drug Saf. 2016;15(7):925-35. PMID: 27074901; doi: 10.1080/14740338.2016.1177021.
Santos M de O. Estimativa 2018: incidência de câncer no Brasil. Revista Brasileira de Cancerologia. 2018; 64(1):119-20. doi: 10.32635/2176-9745.RBC.2018v64n1.115.
Martins MA, Martins MD, Lascala CA, et al. Association of laser phototherapy with PRP improves healing of bisphosphonate-related osteonecrosis of the jaws in cancer patients: a preliminary study. Oral Oncol. 2012;48(1):79-84. PMID: 21940198; doi: 10.1016/j.oraloncology.2011.08.010.
Farias DS, Zen Filho EV, de Oliveira TF, et al. Clinical and image findings in bisphosphonate-related osteonecrosis of the jaws. J Craniofac Surg. 2013;24(4):1248-51. PMID: 23851781; doi: 10.1097/SCS.0b013e3182902b91.
Rabelo GD, Assunção JN Jr, Chavassieux P, et al. Bisphosphonate-Related Osteonecrosis of the Jaws and Its Array of Manifestations. J Maxillofac Oral Surg. 2015;14(3):699-705. PMID: 26225065; doi: 10.1007/s12663-014-0707-8.
Mathias Duarte LF, dos Reis HB, Tucci R, Dib LL. Bisphosphonate-related osteonecrosis of the jaws: analysis of a case series at a dental school. Spec Care Dentist. 2014;34(2):77-83. PMID: 23875734; doi: 10.1111/scd.12023.
Heggendorn FL, Leite TC, Cunha KS, et al. Bisphosphonate-related osteonecrosis of the jaws: Report of a case using conservative protocol. Spec Care Dentist. 2016;36(1):43-7. PMID: 26782365; doi: 10.1111/scd.12143.
Antonini F, Pereira CCS, Parente EV, Azambuja FG. Management of osteonecrosis of the jaws in patients with history of bisphosphonates therapy. J Craniofac Surg. 2010;21(6):1962-6. PMID: 21119470; doi : 10.1097/SCS.0b013e3181f4ee4e.
Maluf G, Caldas RJ, Silva Santos PS. Use of leukocyte-and platelet-rich fibrin in the treatment of medication-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2018;76(1):88-96. PMID: 28675810; doi: 10.1016/j.joms.2017.06.004.
Momesso GAC, de Souza Batista FR, de Sousa CA, et al. Successful use of lower-level laser therapy in the treatment of medication-related osteonecrosis of the jaw. J Lasers Med Sci. 2017;8(4):201-3. PMID: 29071028; doi: 10.22037/jlms.v8i4.16701.
de Oliveira Ruellas AM, Peruzzo DC, Napimoga MH. Managing bisphosphonate‐related osteonecrosis of the jaws with xenografts: a case report. Clin Case Rep. 2017;5(8):1395-400. PMID: 28781866; doi: 10.1002/ccr3.1085.
Fernando de Almeida Barros Mourão C, Calasans-Maia MD, Del Fabbro M, et al. The use of Platelet-rich Fibrin in the management of medication-related osteonecrosis of the jaw: A case series. J Stomatol Oral Maxillofac Surg. 2020;121(1):84-9. PMID: 30794883; 10.1016/j.jormas.2019.02.011.
Santos M, Silveira K, Souza N, Costa D, Inaoka S. Extensive osteonecrosis of the maxilla caused by bisphosphonates: Report of a rare case. J Clin Exp Dent. 2019;11(2):e203-e207. PMID: 30805126; doi: 10.4317/jced.55151.
Hoff AO, Toth BB, Altundag K, et al. Frequency and risk factors associated with osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. J Bone Miner Res. 2008;23(6):826-36. PMID: 18558816; doi: 10.1359/jbmr.080205.
Barasch A, Cunha-Cruz J, Curro F, et al. Dental risk factors for osteonecrosis of the jaws: a CONDOR case-control study. Clin Oral Investig. 2013;17(8):1839-45. PMID: 23212125; doi: 10.1007/s00784-012-0880-4.
O’Ryan FS, Lo JC. Bisphosphonate-related osteonecrosis of the jaw in patients with oral bisphosphonate exposure: clinical course and outcomes. J Oral Maxillofac Surg. 2012;70(8):1844-53. PMID: 22595135; doi: 10.1016/j.joms.2011.08.033.
Mercer E, Norton T, Woo S, et al. Ninety-one osteoporosis patients affected with bisphosphonate-related osteonecrosis of the jaw: a case series. Calcif Tissue Int. 2013;93(3):241-8. PMID: 23756612; doi: 10.1007/s00223-013-9747-1.
Di Fede O, Bedogni A, Giancola F, et al; BRONJ in patients with rheumatoid arthritis: a multicenter case series. Oral Dis. 2016;22(6):543-8. PMID: 27062502; doi: 10.1111/odi.12490.
Vahtsevanos K, Kyrgidis A, Verrou E, et al. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. J Clin Oncol. 2009;27(32):5356-62. PMID: 19805682; doi: 10.1200/JCO.2009.21.9584.
Saad F, Brown JE, Van Poznak C, et al. Incidence, risk factors, and outcomes of osteonecrosis of the jaw: integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases. Ann Oncol. 2012;23(5):1341-7. PMID: 21986094; doi: 10.1093/annonc/mdr435.
Fehm T, Beck V, Banys M, et al. Bisphosphonate-induced osteonecrosis of the jaw (ONJ): Incidence and risk factors in patients with breast cancer and gynecological malignancies. Gynecol Oncol. 2009;112(3):605-9. PMID: 19136147; doi: 10.1016/j.ygyno.2008.11.029.
Pichardo SE, Kuijpers SC, van Merkesteyn JP. Bisphosphonate-related osteonecrosis of the jaws: Cohort study of surgical treatment results in seventy-four stage II/III patients. J Craniomaxillofac Surg. 2016;44(9):1216-20. PMID: 27421170; doi: 10.1016/j.jcms.2016.06.016.
Blus C, Giannelli G, Szmukler-Moncler S, Orru G. Treatment of medication-related osteonecrosis of the jaws (MRONJ) with ultrasonic piezoelectric bone surgery. A case series of 20 treated sites. Oral Maxillofac Surg. 2017;21(1):41-8. PMID: 27924427; doi: 10.1007/s10006-016-0597-7.
Bagan JV, Cibrian RM, Lopez J, et al. Sclerosis in bisphosphonate-related osteonecrosis of the jaws and its correlation with the clinical stages: study of 43 cases. Br J Oral Maxillofac Surg. 2015;53(3):257-62. PMID: 25560326; doi: 10.1016/j.bjoms.2014.12.004.
Nisi M, La Ferla F, Karapetsa D, et al. Conservative surgical management of patients with bisphosphonate-related osteonecrosis of the jaws: a series of 120 patients. Br J Oral Maxillofac Surg. 2016;54(8):930-5. PMID: 27418080; doi: 10.1016/j.bjoms.2016.06.015.
Sammut S, Malden N, Lopes V, Ralston S. Epidemiological study of alendronate-related osteonecrosis of the jaw in the southeast of Scotland. Br J Oral Maxillofac Surg. 2016;54:501-505.
Nomura T, Shibahara T, Uchiyama T, et al. Bisphosphonate-related osteonecrosis of jaw (BRONJ) in Japanese population: a case series of 13 patients at our clinic. Bull Tokyo Dent Coll. 2013;54(2):117-25. PMID: 23903583; doi: 10.2209/tdcpublication.54.117.
Kim HJ, Tae-Jun P, Ahn KM. Bisphosphonate-related osteonecrosis of the jaw in metastatic breast cancer patients: a review of 25 cases. Maxillofac Plast Reconstr Surg. 2016;38(1):6. PMID: 26870717; doi: 10.1186/s40902-016-0052-6.
Hong SO, Lee CY, Jung J, et al. A retrospective study of osteomyelitis and osteonecrosis of the jaws and its etiologic implication of bisphosphonate in Asians. Clin Oral Invest. 2017;21(5):1905-11. PMID: 27771829; doi: 10.1007/s00784-016-1973-2.
Kim TH, Seo WG, Koo CH, Lee JH. Evaluation of the predisposing factors and involved outcome of surgical treatment in bisphosphonate-related osteonecrosis of the jaw cases including bone biopsies. J Korean Assoc Oral Maxillofac Surg. 2016;42(4):193-204. PMID: 27595086; doi: 10.5125/jkaoms.2016.42.4.193.
Guazzo R, Sbricoli L, Ricci S, et al. Medication-related osteonecrosis of the jaw and dental implants failures: a systematic review. J Oral Implantol. 2017;43(1):51-7. PMID: 28231038; doi: 10.1563/aaid-joi-16-00057.
Kyrgidis A, Vahtsevanos K, Koloutsos G, et al. Bisphosphonate-related osteonecrosis of the jaws: a case-control study of risk factors in breast cancer patients. J Clin Oncol. 2008;26(28):4634-8. PMID: 18574158; doi: 10.1200/JCO.2008.16.2768.
Watters AL, Hansen HJ, Williams T, et al. Intravenous bisphosphonate-related osteonecrosis of the jaw: long-term follow-up of 109 patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(2):192-200. PMID: 23036797; doi: 10.1016/j.oooo.2012.05.017.
Bodem JP, Schaal C, Kargus S, et al. Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;121(4):367-72. PMID: 26795450; doi: 10.1016/j.oooo.2015.10.033.
Nørholt SE, Hartlev J. Surgical treatment of osteonecrosis of the jaw with the use of platelet-rich fibrin: a prospective study of 15 patients. Int J Oral Maxillofac Surg. 2016;45(10):1256-60. PMID: 27179556; doi: 10.1016/j.ijom.2016.04.010.
Kim SM, Eo MY, Kim YS, Lee SK. Histochemical observation of bony reversal lines in bisphosphonate-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123(2):220-8. PMID: 27989705; doi: 10.1016/j.oooo.2016.09.225.
Dimopoulos MA, Kastritis E, Anagnostopoulos A, et al. Osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates: evidence of increased risk after treatment with zoledronic acid. Haematologica. 2006;91(7):968-71. PMID: 16757414.
Zervas K, Verrou E, Teleioudis Z, et al. Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: a single‐centre experience in 303 patients. Br J Haematol. 2006;134(6):620-3. PMID: 16889620; doi: 10.1111/j.1365-2141.2006.06230.x.
Pozzi S, Marcheselli R, Sacchi S, et al. Bisphosphonate-associated osteonecrosis of the jaw: a review of 35 cases and an evaluation of its frequency in multiple myeloma patients. Leuk Lymphoma. 2007;48(1):56-64. PMID: 17325848; doi: 10.1080/10428190600977690.
Karasneh JA, Al-Eryani K, Clark GT, Sedghizadeh PP. Modified protocol including topical minocycline in orabase to manage medication-related osteonecrosis of the jaw cases. J Oral Pathol Med. 2016;45(9):718-20. PMID: 26750149; doi: 10.1111/jop.12419.
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