Novel insight into the management of bisphosphonate-related osteonecrosis of the jaw (BRONJ)

Publication date: November 2019Source: Japanese Dental Science Review, Volume 55, Issue 1Author(s): Hiromitsu Kishimoto, Kazuma Noguchi, Kazuki TakaokaSummaryBisphosphonate-related osteonecrosis of the jaw (BRONJ), characterized by refractory bone exposure, has recently emerged as a serious side effect of bisphosphonate (BPs) treatment. We discuss novel insights that may help to improve the efficacy of BRONJ treatment and prevention. Our report highlights the following: (1) The presence of exposed bone in patients taking BPs does not necessarily reflect BRONJ, and diagnoses of oral ulceration with bone sequestration and malignancy must be excluded. (2) Osteonecrosis type of BRONJ is difficult to avoid using preventive dental measures alone. However, as with osteomyelitis type of BRONJ, preventive dental measures are indispensable for reducing the risk of secondary infection and disease progression. (3) The importance of tooth extraction as a risk factor for BRONJ among patients taking BPs has been overstated, particularly when they are administered at low doses. Delaying tooth extraction may increase the risk for the onset and progression of osteomyelitic BRONJ. (4) In patients taking low doses of BPs, dental implant surgery is not necessarily contraindicated if there are no other risk factors, such as combined use of corticosteroids or concomitant diabetes. However, the risk of BRONJ due to peri-implantitis must be explained when obtaining patient consent.
Source: Japanese Dental Science Review - Category: Dentistry Source Type: research

Related Links:

CONCLUSION: This study of recurrences was clearly related to the type and complications of the ulcers rather than to the other variables. Recurrent foot ulceration is linked to the presence of osteomyelitis and/or deformities. PMID: 31916518 [PubMed - as supplied by publisher]
Source: Current Diabetes Reviews - Category: Endocrinology Authors: Tags: Curr Diabetes Rev Source Type: research
Summary: Chronic radiation-induced osteomyelitis/necrosis of the rib was rarely encountered in breast cancer patients even before the era of breast-conserving therapy. Few studies have focused on how to evaluate the extent of rib osteomyelitis for surgical management. A 78-year-old woman who had received radiation therapy after a radical mastectomy due to breast cancer 30 years ago manifested a rib pain and chest skin ulcers. Because chest magnetic resonance imaging failed to visualize osteomyelitis of the rib, a wide-ranged rib resection was initially planned considering her radiation field. An additional imaging, 3-dim...
Source: Plastic and Reconstructive Surgery Global Open - Category: Cosmetic Surgery Tags: Case Report Source Type: research
ConclusionOur meta-analysis indicated that ischemic ulcer, ulcer size, ulcer grade, osteomyelitis, previous antibiotic therapy and previous hospitalization were associated with MDRO infection in patients with diabetic foot ulcers.
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Publication date: November 2019Source: The Journal of Foot and Ankle Surgery, Volume 58, Issue 6Author(s): Nicole K. Cates, Tammer Elmarsafi, Taylor J. Bunka, Elliot T. Walters, Cameron M. Akbari, Caitlin Zarick, Karen K. Evans, John S. Steinberg, Christopher E. Attinger, Paul J. KimAbstractPostreconstructive outcomes were compared in diabetic patients with Charcot neuroarthropathy (CN) who had peripheral arterial disease (PAD) diagnosed with angiography versus patients who were diagnosed clinically. A retrospective review was performed of patients with diabetic CN requiring reconstruction secondary to ulceration and/or ac...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Abstract Introduction: Considering the importance of early diagnosis of diabetic foot ulcers and its complications, this study aimed to evaluate the accuracy of erythrocyte sedimentation rate (ESR), C - reactive protein (CRP), and pro-calcitonin (PCT) in predicting the ulcer class, osteomyelitis, and peripheral arterial disease (PAD). Methods: This cross-sectional study was performed on 200 consecutive patients suffering from diabetic foot ulcer who were referred to Infectious Disease Ward. The levels of PCT, ESR, and CRP were measured for all patients and the screening performance characteristics of each mar...
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
This study aimed to determine the seizure frequency and assess the clinical benefit of a 5-minute air-break (5´-AIRBK). METHODS: Twenty-year (1999-2018) retrospective analysis of all consecutive treatments with HBOT. Medical records were reviewed to determine patient demographics, comorbidities, HBOT indications, and seizure characteristics and timing. Seizure frequency was compared before and after incorporating a 5´-AIRBK in the treatment protocol. Chi-square testing was performed using SPSS (version 24.0); P
Source: Diving and Hyperbaric Medicine - Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research
Condition:   Diabetic Foot Ulcer Intervention:   Sponsor:   University of Texas Southwestern Medical Center Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract BACKGROUND: Charcot neuropathy is a severe complication in patients with neuropathy. Without treatment, CN can lead to a destruction and collapse of the foot, with subsequent ulceration and infection. Finding an early diagnosis is essential and is based on clinical and radiological parameters (X-ray and MRI) because there is still no specific and reliable test. GOAL: Defining and validation of a Charcot score with defined histopathologic criteria. METHOD: Tissue samples from 37 surgeries (Charcot-group n = 20, control-group n = 17) from tarsal bones were tak...
Source: Der Orthopade - Category: Orthopaedics Authors: Tags: Orthopade Source Type: research
More News: Cancer & Oncology | Corticosteroid Therapy | Dentistry | Diabetes | Diabetic Ulcers | Endocrinology | Japan Health | Osteomyelitis | Science