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Bisphosphonate-Related Osteonecrosis of the Jaws and Its Array of Manifestations

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Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Purpose

Bisphosphonate (BP) therapy in the treatment of bone diseases and malignancy may induce a major side effect known as bisphosphonate-related osteonecrosis of the jaws (BRONJ). A particular view of this condition is reported in this case series investigating eight patients. The aim of the study was to evaluate the BRONJ lesions concerning their aspects and progression. Also, identify if it is possible to predict the degree of severity in these cases.

Methods

Patients were evaluated by their condition and systemic health. The lesions were evaluated in clinical and radiographic aspects. The patients were followed-up for 2 years.

Results

The patients presented with specific peculiarities, and the BRONJ lesions varied in several characteristics. The BRONJ lesions ranged from simple to severe conditions, and the complicated cases presented with major pain, swelling, secondary infection and an extensive necrotic area, classified with high grade of severity.

Conclusions

The patients presented here confirm the existence of a relation between multiple features and BRONJ and to understand the whole process of aggravation, all systemic and local information have to be taken into account, together with all data related to the BP utilized. Regardless of the low incidence of this side effect in relation to osteoporosis treatment, in some cases, the BRONJ may become a severe condition and compromise the patient’s quality of life.

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Acknowledgments

The author (GDR) thanks the “Ciência sem Fronteiras – CNPq” (Processo número 245336/2012-5) program for the Post-doc scholarship.

Conflict of interest

None.

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Authors and Affiliations

  1. UFR de Médecine Lyon-Est Domaine Laennec, INSERM UMR 1033, Université de Lyon, 7-11 Rue Guillaume Paradin, 69372, Lyon Cedex 08, France

    Gustavo Davi Rabelo & Pascale Chavassieux

  2. Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000, Brazil

    Gustavo Davi Rabelo, José Narciso Rosa Assunção Jr., Fabio Abreu Alves & Celso Augusto Lemos Jr.

  3. Santos Metropolitan University, Rua da Constituição 374, Vila Nova, Santos, 11015-470, Brazil

    José Narciso Rosa Assunção Jr. & Haroldo Arid Soares

  4. A. C. Camargo Cancer Center, Fundação Antonio Prudente, Rua Professor Antônio Prudente 211, São Paulo, 01509-900, Brazil

    Gustavo Davi Rabelo & Fabio Abreu Alves

Authors
  1. Gustavo Davi Rabelo
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  2. José Narciso Rosa Assunção Jr.
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  3. Pascale Chavassieux
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  4. Haroldo Arid Soares
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  5. Fabio Abreu Alves
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  6. Celso Augusto Lemos Jr.
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Corresponding author

Correspondence to Gustavo Davi Rabelo.

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Rabelo, G.D., Assunção, J.N.R., Chavassieux, P. et al. Bisphosphonate-Related Osteonecrosis of the Jaws and Its Array of Manifestations. J. Maxillofac. Oral Surg. 14, 699–705 (2015). https://doi.org/10.1007/s12663-014-0707-8

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  • DOI: https://doi.org/10.1007/s12663-014-0707-8

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