Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports
Identifieur interne : 004096 ( Main/Exploration ); précédent : 004095; suivant : 004097Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports
Auteurs : Nicolau Conte-Neto ; Alliny S. Bastos ; Luis C. Spolidorio ; Rosemary Ac Marcantonio ; Elcio MarcantonioSource :
- Head & Face Medicine [ 1746-160X ] ; 2011.
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition characterized by the presence of exposed bone in the maxillofacial region. Its pathogenesis is still undetermined, but may be associated with risk factors such as rheumatoid arthritis (RA). The aim of this paper is to report two unpublished cases of BRONJ in patients with RA and to conduct a literature review of similar clinical cases with a view to describe the main issues concerning these patients, including demographic characteristics and therapeutic approaches applied.
Two case reports of BRONJ involving RA patients were discussed
Both patients were aging female taking alendronate for more than 3 years. Lesions were detected in stage II in posterior mandible with no clear trigger agent. The treatment applied consisted of antibiotics, oral rinses with chlorhexidine, drug discontinuation and surgical procedures. Complete healing of the lesions was achieved.
This paper brings to light the necessity for rheumatologists to be aware of the potential risk to their patients of developing BRONJ and to work together with dentists for the prevention and early detection of the lesions. Although some features seem to link RA with oral BRONJ and act as synergistic effects, more studies should be developed to support the scientific bases for this hypothesis.
Url:
DOI: 10.1186/1746-160X-7-7
PubMed: 21524309
PubMed Central: 3111349
Affiliations:
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Estadual Paulista, School of Dentistry, Department of Diagnosis and Surgery, Division of Periodontology, Rua Humaitá, 1680, 14801-903 Araraquara, SP/Brazil</nlm:aff><wicri:noCountry code="subfield">SP/Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Bastos, Alliny S" sort="Bastos, Alliny S" uniqKey="Bastos A" first="Alliny S" last="Bastos">Alliny S. Bastos</name><affiliation><nlm:aff id="I1">UNESP - Univ. Estadual Paulista, School of Dentistry, Department of Diagnosis and Surgery, Division of Periodontology, Rua Humaitá, 1680, 14801-903 Araraquara, SP/Brazil</nlm:aff><wicri:noCountry code="subfield">SP/Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Spolidorio, Luis C" sort="Spolidorio, Luis C" uniqKey="Spolidorio L" first="Luis C" last="Spolidorio">Luis C. Spolidorio</name><affiliation><nlm:aff id="I2">UNESP - Univ. Estadual Paulista, School of Dentistry, Department of Physiology and, Pathology, Division of Pathology, Rua Humaitá, 1680, 14801-903 Araraquara, SP/Brazil</nlm:aff><wicri:noCountry code="subfield">SP/Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Marcantonio, Rosemary Ac" sort="Marcantonio, Rosemary Ac" uniqKey="Marcantonio R" first="Rosemary Ac" last="Marcantonio">Rosemary Ac Marcantonio</name><affiliation><nlm:aff id="I1">UNESP - Univ. Estadual Paulista, School of Dentistry, Department of Diagnosis and Surgery, Division of Periodontology, Rua Humaitá, 1680, 14801-903 Araraquara, SP/Brazil</nlm:aff><wicri:noCountry code="subfield">SP/Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Marcantonio, Elcio" sort="Marcantonio, Elcio" uniqKey="Marcantonio E" first="Elcio" last="Marcantonio">Elcio Marcantonio</name><affiliation><nlm:aff id="I1">UNESP - Univ. Estadual Paulista, School of Dentistry, Department of Diagnosis and Surgery, Division of Periodontology, Rua Humaitá, 1680, 14801-903 Araraquara, SP/Brazil</nlm:aff><wicri:noCountry code="subfield">SP/Brazil</wicri:noCountry></affiliation></author></analytic><series><title level="j">Head & Face Medicine</title><idno type="eISSN">1746-160X</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition characterized by the presence of exposed bone in the maxillofacial region. Its pathogenesis is still undetermined, but may be associated with risk factors such as rheumatoid arthritis (RA). The aim of this paper is to report two unpublished cases of BRONJ in patients with RA and to conduct a literature review of similar clinical cases with a view to describe the main issues concerning these patients, including demographic characteristics and therapeutic approaches applied.</p></sec><sec><title>Methods</title><p>Two case reports of BRONJ involving RA patients were discussed</p></sec><sec><title>Results</title><p>Both patients were aging female taking alendronate for more than 3 years. Lesions were detected in stage II in posterior mandible with no clear trigger agent. The treatment applied consisted of antibiotics, oral rinses with chlorhexidine, drug discontinuation and surgical procedures. Complete healing of the lesions was achieved.</p></sec><sec><title>Conclusions</title><p>This paper brings to light the necessity for rheumatologists to be aware of the potential risk to their patients of developing BRONJ and to work together with dentists for the prevention and early detection of the lesions. Although some features seem to link RA with oral BRONJ and act as synergistic effects, more studies should be developed to support the scientific bases for this hypothesis.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Park, W" uniqKey="Park W">W Park</name></author><author><name sortKey="Kim, Nk" uniqKey="Kim N">NK Kim</name></author><author><name sortKey="Kim, My" uniqKey="Kim M">MY Kim</name></author><author><name sortKey="Rhee, Ym" uniqKey="Rhee Y">YM Rhee</name></author><author><name sortKey="Kim, Hj" uniqKey="Kim H">HJ Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Malden, N" uniqKey="Malden N">N Malden</name></author><author><name sortKey="Beltes, C" uniqKey="Beltes C">C Beltes</name></author><author><name sortKey="Lopes, V" uniqKey="Lopes V">V Lopes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alamanos, Y" uniqKey="Alamanos Y">Y 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Bastos</name><name sortKey="Conte Neto, Nicolau" sort="Conte Neto, Nicolau" uniqKey="Conte Neto N" first="Nicolau" last="Conte-Neto">Nicolau Conte-Neto</name><name sortKey="Marcantonio, Elcio" sort="Marcantonio, Elcio" uniqKey="Marcantonio E" first="Elcio" last="Marcantonio">Elcio Marcantonio</name><name sortKey="Marcantonio, Rosemary Ac" sort="Marcantonio, Rosemary Ac" uniqKey="Marcantonio R" first="Rosemary Ac" last="Marcantonio">Rosemary Ac Marcantonio</name><name sortKey="Spolidorio, Luis C" sort="Spolidorio, Luis C" uniqKey="Spolidorio L" first="Luis C" last="Spolidorio">Luis C. Spolidorio</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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