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1.
The introduction of bisphosphonates has increased in the last decade following their indication for metastatic bone diseases,
osteoporosis, hypercalcaemia of malignancy and Paget’s disease. Although bisphosphonates have been used clinically for more
than three decades there have been no documented long-term complications of their effects on the jaws until recently, where
there is now growing evidence of the influence of bisphosphonates on osteonecrosis of the jaws. The aim of this paper is to
report a case of this newly described complication, to review this phenomenon, including the clinical implications and to
reiterate current clinical guidelines for management of patients in which bisphosphonate therapy is indicated. To the best
of our knowledge this is the first reported case of bisphosphonate-induced necrosis of the jaw in South Africa. 相似文献
2.
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is mainly observed in patients with multiple myeloma and bone metastasis
from solid tumors receiving iv bisphosphonate therapy. The reported incidence of BRONJ is significantly higher with the iv
preparations zoledronic acid and pamidronate while the risk appears to be minimal for patients receiving oral bisphosphonates.
Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence
range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60–70% of cases are preceded
by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis
include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue
infection. Although the definitive role of bisphosphonates remains to be elucidated, the inhibition of physiologic bone remodeling
and angiogenesis by these potent drugs impairs the regenerative capacity of the bone causing the development of BRONJ. Tooth
extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients
clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated,
should be provided with preventive dental care in order to minimize the risk of developing this severe condition. This article
provides an update review of current knowledge about clinical, pathological and management aspects of BRONJ. 相似文献
3.
John Lennon Silva Cunha Carla Isabelly Rodrigues-Fernandes Ciro Dantas Soares Celeste Snchez-Romero Pablo Agustin Vargas Cleverson Luciano Trento Bruno Augusto Benevenuto de Andrade Sílvia Ferreira de Sousa Ricardo Luiz Cavalcanti de Albuquerque-Júnior 《Head and neck pathology》2021,15(1):303
Myofibroma (MF) is a benign mesenchymal myofibroblast-derived tumor, which occurs most frequently in children, and rarely affects the maxilla. We reported a case of an aggressive intraosseous lesion found in the maxilla of a 9-year-old female child. Intraorally, the swelling extended from tooth 12 to 16, causing displacement of teeth 13, 14, and 15. Computed tomography revealed a large osteolytic lesion causing thinning and cortical erosion. Microscopically, the lesion showed a proliferation of spindle-shaped cells, with elongated nuclei and eosinophilic cytoplasm, arranged in interlaced fascicles. The immunohistochemical analysis revealed cytoplasmic positivity for α-SMA and HHF-35, and negativity for desmin, laminin, S-100, β-catenin, and CD34. Ki-67 was positive in 8% of tumor cells. The diagnosis was MF. Herein, we describe an additional case of central MF arising in the maxilla, including clinical, imaging, microscopical, and immunohistochemical features, as well as a review of the literature. 相似文献
4.
为探讨成釉细胞纤维肉瘤( A F S)间叶细胞的本质及特征, 作者采用免疫组化和电镜技术,对3例 A F S间叶细胞进行了研究,并与6例成釉细胞纤维瘤进行比较。结果显示: A F S的间叶细胞主要由成纤维细胞构成,此外尚有少许未分化间叶细胞和组织细胞, 偶见肌纤维母细胞。成纤维细胞仅表现 Vim entin 阳性。肌纤维母细胞呈 Vim entin, H H F35及 α S M A 阳性。组织细胞 P G M1 和kp1标记均阳性, 可能是炎症或免疫反应的产物。与成釉细胞纤维瘤比较, A F S间叶细胞具备较高的 P C N A 阳性标记率, 提示 A F S的增生活性较高。 相似文献
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7.
Mariana Camilo Negreiros Lyrio Adriano Freitas de Assis Adriano Rocha Germano Mrcio de Moraes 《The British journal of oral & maxillofacial surgery》2010,48(8):651-653
Glandular odontogenic cysts of the jaw are rare with unusual histopathological features, well-defined limits, and a high recurrence rate when treated conservatively. We describe a 37-year-old white man with such a cyst of the right mandible that was resected, and at follow-up 5 years later there were no signs of recurrence. 相似文献
8.
目的:探讨全中枢神经系统放射治疗中,脊髓布野及全脊髓野与全脑野间衔接的方法。方法:采用我院与浙江大学联合研制的平移扫描治疗装置,在^60Co治疗机上对全脊髓进行平移扫描照射以及用一个等中心、半束整体铅摸照射全脑。结果:根据测量全脊髓内及脊髓与全脑衔接处以及全脑内剂量分布满意,无冷点或热点,符合QA。讨论:全中枢神经系统放射治疗时,采用平移扫描治疗全脊髓及等中心半束整体铅模照射全脑.全脑、髓内以及衔接处剂量满意。 相似文献
9.
N. Yarom R. Yahalom Y. Shoshani W. Hamed E. Regev S. Elad 《Osteoporosis international》2007,18(10):1363-1370
Summary Osteonecrosis of the jaw (ONJ) is a well-known devastating side effect of bisphosphonate therapy for cancer. Several ONJ cases
of patients using oral bisphosphonates have been reported in the literature. The present study analyzed the clinical features,
predisposing factors, and treatment outcome of 11 patients with oral bisphosphonates-related ONJ.
Introduction and hypothesis Osteonecrosis of the jaw (ONJ) is a well-known side effect of parenteral bisphosphonates therapy. Although ONJ has been reported
in patients using oral bisphosphonates, documentation of this entity is sparse. It was hypothesized that the clinical features,
predisposing factors, and treatment outcome of this population are different from those of oncologic patients.
Methods This retrospective bi-central study involved 98 ONJ patients, 13 of whom were treated with oral bisphosphonates. Two patients
were excluded because of previous use of intravenous bisphosphonates. The profiles of 11 patients were analyzed.
Results The mean duration of alendronate use before developing ONJ was 4.1 years. ONJ was triggered by dental surgery in 9 patients
and by ill-fitted dentures in 2. Heavy smokers were the most recalcitrant subjects. Among the nine patients with at least
6 months of follow-up, ONJ healed completely in three, partially in four, and not at all in two.
Conclusions ONJ is a rare devastating side effect of oral bisphosphonates associated with patient morbidity and high financial burden.
Clinicians must be aware of this entity and inform patients of the risks of dental surgery. The synergistic effect of smoking
in the pathogenesis of ONJ should be further investigated. 相似文献
10.