Document Detail

New therapeutic protocol in the treatment of avascular necrosis of the jaws.
MedLine Citation:
PMID:  17119409     Owner:  NLM     Status:  MEDLINE    
Osteonecrosis of the jaws is being increasingly reported in patients with bone metastasis from a variety of solid tumors and disseminated multiple myeloma receiving intravenous bisphosphonates. Agreement exists that these drugs can initiate vascular endothelial cell damage and accelerate disturbances in the microcirculation of the jaws, possibly resulting in thrombosis of nutrient-end arteries. The role of bisphosphonates in cancer patients with previously treated jaws has yet to be elucidated. The signs and symptoms that may occur before the appearance of evident osteonecrosis include changes in the health of periodontal tissues, nonhealing mucosal ulcers, loose teeth and unexplained soft tissue infection. A series of 30 periodontally involved patients showing osteonecrosis of the jaws that appeared following the intravenous use of bisphosphonates is reported. Clinical management of the avascular necrosis of the jaws in patients treated with bisphosphonates presents several problems. An analysis of the international medical literature shows that surgical treatment of the necrotic jaws in patients treated with bisphosphonates has proven to be ineffective in stopping the pathological process. The use of hyperbaric oxygen and antibiotics are not effective, either. The authors have developed a new protocol for the management of these lesions. Compared with other therapeutic choices, this protocol has introduced the use of ozone therapy as therapeutic support.
Alessandro Agrillo; Maria Teresa Petrucci; Massimiliano Tedaldi; Maria Cristina Mustazza; Simone Maria Faustino Marino; Cristiano Gallucci; Giorgio Iannetti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  17     ISSN:  1049-2275     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-22     Completed Date:  2007-05-08     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1080-3     Citation Subset:  D    
Department of Maxillo-Facial Surgery, University of Rome "La Sapienza," Policlinico Umberto I, Rome, Italy.
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MeSH Terms
Bone Density Conservation Agents / adverse effects
Diphosphonates / adverse effects
Jaw Diseases / chemically induced,  therapy*
Middle Aged
Osteonecrosis / chemically induced,  therapy*
Ozone / therapeutic use*
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Diphosphonates; 10028-15-6/Ozone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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