Titre
Bisphosphonate-related osteonecrosis of the jaws: how to manage cancer patients.
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Madrid, C.
Auteure/Auteur
Bouferrache, K.
Auteure/Auteur
Abarca, M.
Auteure/Auteur
Jaques, B.
Auteure/Auteur
Broome, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1368-8375
Statut éditorial
Publié
Date de publication
2010
Volume
46
Numéro
6
Première page
468
Dernière page/numéro d’article
470
Langue
anglais
Résumé
Bisphosphonate related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone appearing in the jaws of patients treated by systemic IV or oral BPs never irradiated in the head and neck area and that has persisted for more than 8 weeks. More than 90% of cases of osteonecrosis of the jaw have been in patients with cancer who received IV-BPs. The estimate of cumulative incidence of BRONJ in cancer patients with IV-BPs ranges from 0.8% to 18.6%. The pathogenesis of BRONJ appeared related to the potent osteoblast-inhibiting properties of BPs which act by blocking osteoclast recruitment, decreasing osteoclast activity and promoting osteoclast apoptosis. Dental extractions are the most potent local risk factor. Cancer patients wearing a denture could also be at increased risk of BRONJ. Non-healing mucosal breaches caused by dentures could be a portal for the oral flora to access bone, while the oral mucosa of patients on IV-BPs could also be defective. Whether periodontal disease is a risk factor for BRONJ remains controversial. Preventive measures are fundamental. Nevertheless, some teams have questioned its cost-effectiveness. The perceived limitations of surgical therapy of BRONJ led to the restriction of aggressive surgery to symptomatic patients with stage 3 BRONJ. The evidence-based literature on BRONJ is growing but there are still many controversial aspects.
PID Serval
serval:BIB_24DDA5DFECCF
PMID
Date de création
2010-06-30T07:42:16.594Z
Date de création dans IRIS
2025-05-20T18:39:39Z