Aim. Osteonecrosis of the jaw (ONJ) is a serious sideeffect of amine bisphosphonate (NBP) and/or other antiresorptive agents frequently used in the management of osteometabolic and cancer-related condition. The traditional ONJ definition exclude patients who present the non-exposed variant. However, according to recent data, staging and monitoring of ONJ should be closely linked to clinical and radiological manifestation regardless of the presence of bone exposed. The aim of this study was a descriptive analysis of a case series of patients with non-exposed ONJ (exclusively related to NBP) monitoring for two years. Methods. From 2012 to 2014, 16 patient [7 oncological (F/M=3/4; mean age=66,28 years) and 9 osteoporotic (F/ M=9/0; mean age=67,22 years)] with non-exposed ONJ, clinically and radiologically confirmed, were consecutively enrolled. All oncological patients took zolendronate (IV); the majority of osteoporotic patients (44,4%) used alendronate (OS). All patients were staged at diagnosis (T0) and treated according to SICMF/SIPMO recommendations (www.sipmo.it); then were monitored for 24 months especially focusing on bone exposition. During the followup period, data on symptoms (presence/absence of pain) and/or clinical and radiological ONJ status (i.e. reduction or extension of necrotic bone, occurrence or remission of intraoral/extraoral fistula) were registered. Finally, a new staging was carried at the end of monitoring time (T1). A descriptive analysis was performed. Results. At T0, 8 patients (50%) were staged as early ONJ (stage 1), 6 patients (37,5%) as advanced (stage 2) and 2 patients (12,5%) as complicated (stage 3). At T1, among the 8 patients with stage 1, 6 maintained the non-exposed bone condition and 7 the same stage; for the 6 patients with stage 2, 2 maintained the non-exposed bone condition, 2 healed and 2 died during the follow-up period. About pain, the majority of patients (62,5%) have experienced an improvement of their symptoms. Conclusion. In the majority of supervised patients, the bone exposition has not occurred during the two years of follow-up. As well as for diagnosis, also for the monitoring of patients of ONJ, other clinical ad instrumental features must be considered.

V. Panzarella, F.G. (2015). Follow-up of non-exposed ONJ related to bisphosphonate: a two-year study. In MINERVA STOMATOLOGICA (pp.170-170).

Follow-up of non-exposed ONJ related to bisphosphonate: a two-year study

Giancola, Francesco;DI FEDE, Olga
2015-01-01

Abstract

Aim. Osteonecrosis of the jaw (ONJ) is a serious sideeffect of amine bisphosphonate (NBP) and/or other antiresorptive agents frequently used in the management of osteometabolic and cancer-related condition. The traditional ONJ definition exclude patients who present the non-exposed variant. However, according to recent data, staging and monitoring of ONJ should be closely linked to clinical and radiological manifestation regardless of the presence of bone exposed. The aim of this study was a descriptive analysis of a case series of patients with non-exposed ONJ (exclusively related to NBP) monitoring for two years. Methods. From 2012 to 2014, 16 patient [7 oncological (F/M=3/4; mean age=66,28 years) and 9 osteoporotic (F/ M=9/0; mean age=67,22 years)] with non-exposed ONJ, clinically and radiologically confirmed, were consecutively enrolled. All oncological patients took zolendronate (IV); the majority of osteoporotic patients (44,4%) used alendronate (OS). All patients were staged at diagnosis (T0) and treated according to SICMF/SIPMO recommendations (www.sipmo.it); then were monitored for 24 months especially focusing on bone exposition. During the followup period, data on symptoms (presence/absence of pain) and/or clinical and radiological ONJ status (i.e. reduction or extension of necrotic bone, occurrence or remission of intraoral/extraoral fistula) were registered. Finally, a new staging was carried at the end of monitoring time (T1). A descriptive analysis was performed. Results. At T0, 8 patients (50%) were staged as early ONJ (stage 1), 6 patients (37,5%) as advanced (stage 2) and 2 patients (12,5%) as complicated (stage 3). At T1, among the 8 patients with stage 1, 6 maintained the non-exposed bone condition and 7 the same stage; for the 6 patients with stage 2, 2 maintained the non-exposed bone condition, 2 healed and 2 died during the follow-up period. About pain, the majority of patients (62,5%) have experienced an improvement of their symptoms. Conclusion. In the majority of supervised patients, the bone exposition has not occurred during the two years of follow-up. As well as for diagnosis, also for the monitoring of patients of ONJ, other clinical ad instrumental features must be considered.
9-apr-2015
XXII Congresso Nazionale Collegio Docenti Universitari di Discipline Odontostomatologiche
2015
1
V. Panzarella, F.G. (2015). Follow-up of non-exposed ONJ related to bisphosphonate: a two-year study. In MINERVA STOMATOLOGICA (pp.170-170).
Proceedings (atti dei congressi)
V. Panzarella, F. Giancola, L. Lo Muzio, A. Santarelli, N. Termine, O. Di Fede
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/209927
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