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Thomas DC, Shah SK, Chawla J, Sangalli L. Medications Affecting Outcomes and Prognosis of Dental Treatment: Part 1. Dent Clin North Am 2024; 68:767-783. [PMID: 39244256 DOI: 10.1016/j.cden.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
This article gives valuable insight into the effect of selected groups of medications on dental treatment outcome and prognosis. The review emphasizes the importance of thorough medical history, which may have an impact on the prognosis of dental treatment. We discuss drugs acting on the central nervous system, gastrointestinal tract, respiratory tract, endocrine system, and bone metabolism among others. Other pertinent drugs are discussed elsewhere in this special issue.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
| | | | - Jitendra Chawla
- Department of Dentistry, All India Institute of Medical Sciences, Mangalagiri. Dist, Guntur, Andhra Pradesh, India
| | - Linda Sangalli
- College of Dental Medicine - Illinois, Midwestern University, 555 31st Street, Downers Grove, IL, USA
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Falcon CY, Agnihotri V, Gogia A, Guruswamy Pandian AP. Systemic Factors Affecting Prognosis and Outcome of Endodontic Therapy. Dent Clin North Am 2024; 68:813-826. [PMID: 39244259 DOI: 10.1016/j.cden.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
The successful outcome of endodontic treatment is dependent on the immune response and the reparative potential of the individual. Alteration in the host immune response is a common characteristic shared by both apical periodontitis and systemic diseases. Although infection-induced periapical lesions occur in a localized environment, numerous epidemiologic studies in the last few decades have investigated the potential association between endodontic disease pathogenesis and systemic diseases. The goal of this review is to identify common systematic factors and discuss the effect they may or may not have on the prognosis and outcome of endodontic therapy.
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Affiliation(s)
- Carla Y Falcon
- Diplomate, American Board of Endodontics, Department of Endodontics, Rutgers School of Dental Medicine, 110 Bergen Street, D883, Newark, NJ 07103, USA.
| | - Varsha Agnihotri
- Tend Rockefeller Center, 12 West 48th Street, 4th Floor, New York, NY 10029, USA
| | - Amrita Gogia
- Department of Dental Sciences, Medanta - The Medicity, Sector 38, Gurugram, Haryana 1220011, India
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Lee ES, Tsai MC, Lee JX, Wong C, Cheng YN, Liu AC, Liang YF, Fang CY, Wu CY, Lee IT. Bisphosphonates and Their Connection to Dental Procedures: Exploring Bisphosphonate-Related Osteonecrosis of the Jaws. Cancers (Basel) 2023; 15:5366. [PMID: 38001626 PMCID: PMC10670230 DOI: 10.3390/cancers15225366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Bisphosphonates are widely used to treat osteoporosis and malignant tumors due to their effectiveness in increasing bone density and inhibiting bone resorption. However, their association with bisphosphonate-related osteonecrosis of the jaws (BRONJ) following invasive dental procedures poses a significant challenge. This review explores the functions, mechanisms, and side effects of bisphosphonates, emphasizing their impact on dental procedures. Dental patients receiving bisphosphonate treatment are at higher risk of BRONJ, necessitating dentists' awareness of these risks. Topical bisphosphonate applications enhance dental implant success, by promoting osseointegration and preventing osteoclast apoptosis, and is effective in periodontal treatment. Yet, systemic administration (intravenous or intraoral) significantly increases the risk of BRONJ following dental procedures, particularly in inflamed conditions. Prevention and management of BRONJ involve maintaining oral health, considering alternative treatments, and careful pre-operative and post-operative follow-ups. Future research could focus on finding bisphosphonate alternatives with fewer side effects or developing combinations that reduce BRONJ risk. This review underscores the need for further exploration of bisphosphonates and their implications in dental procedures.
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Affiliation(s)
- Emily Sunny Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - Meng-Chen Tsai
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - Jing-Xuan Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - Chuki Wong
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - You-Ning Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - An-Chi Liu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - You-Fang Liang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
| | - Chih-Yuan Fang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chia-Yu Wu
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei 11031, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - I-Ta Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan; (E.S.L.); (M.-C.T.); (J.-X.L.); (C.W.); (Y.-N.C.); (A.-C.L.); (Y.-F.L.); (C.-Y.F.)
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Mu H, Pang Y, Liu L, Liu J, Liu C. Clinical values of serum Semaphorin 4D (Sema4D) in medication‑related osteonecrosis of the jaw. Eur J Med Res 2023; 28:140. [PMID: 36998031 PMCID: PMC10061851 DOI: 10.1186/s40001-023-01095-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 03/12/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Bisphosphonates (BPs) are widely used in clinical practice to prevent and treat bone metabolism-related diseases. Medication-related osteonecrosis of the jaw (MRONJ) is one of the major sequelae of BPs use. Early prediction and intervention of MRONJ are of great significance. METHODS Ninety-seven patients currently on treatment with BPs or with a history of BPs usage and 45 healthy volunteers undergoing dentoalveolar surgery were included in this study. Participants' serum Semaphorin 4D (Sema4D) levels were measured and analyzed before participants underwent surgery (T0) and after a 12-month follow-up (T1). Kruskal-Wallis test and ROC analysis were used to examine the predictive effect of Sema4D on MRONJ. RESULTS Sema4D levels in serum of patients corresponding to confirmed MRONJ were significantly lower at both T0 and T1 time points compared to non-MRONJ and healthy controls. Sema4D has a statistically predictive effect on the occurrence and diagnosis of MRONJ. Serum Sema4D levels were significantly reduced in MRONJ class 3 patients. MRONJ patients who received intravenous BPs had significantly lower Sema4D levels than those who received oral BPs. CONCLUSION Serum Sema4D level has predictive value for the onset of MRONJ in BPs users within 12 weeks after dentoalveolar surgery.
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Affiliation(s)
- Hong Mu
- Dental Clinic, Cangzhou Central Hospital, Xinhua West Road, Cangzhou, 061000, Hebei, China.
| | - Ying Pang
- Dental Clinic, Cangzhou Central Hospital, Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Lili Liu
- Dental Clinic, Cangzhou Central Hospital, Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Jingbo Liu
- General Department, Cangzhou Stomatological Hospital, Xinhua West Road, Cangzhou, 061000, Hebei, China
| | - Chunsheng Liu
- Department of Oral and Maxillofacial Surgery, Cangzhou People's Hospital, Qingchi Avenue, Cangzhou, 061000, Hebei, China
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Sun J, Cai G, Shen J, Cheng P, Zhang J, Jiang D, Xu X, Lu F, Chen L, Chen H. AS-605240 Blunts Osteoporosis by Inhibition of Bone Resorption. Drug Des Devel Ther 2023; 17:1275-1288. [PMID: 37138583 PMCID: PMC10150757 DOI: 10.2147/dddt.s403231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
Background Osteoporosis is a metabolic bone disease. Osteoclasts are significantly involved in the pathogenesis of osteoporosis. AS-605240 (AS) is a small molecule PI3K-γ inhibitor and is less toxic compared to pan-PI3K inhibitors. AS also exerts multiple biological effects including anti-inflammatory, anti-tumor, and myocardial remodeling promotion. However, the involvement of AS in the differentiation and functions of osteoclasts and the effect of AS in treating patients with osteoporosis is still unclear. Purpose This study aimed to investigate if AS inhibits the differentiation of osteoclasts and resorption of the bones induced by M-CSF and RANKL. Next, we evaluated the therapeutic effects of AS on bone loss in ovariectomy (OVX)-induced osteoporosis mice models. Methods We stimulated bone marrow-derived macrophages with an osteoclast differentiation medium containing different AS concentrations for 6 days or 5μM AS at different times. Next, we performed tartrate-resistant acid phosphatase (TRAP) staining, bone resorption assay, F-actin ring fluorescence, real-time quantitative polymerase chain reaction (RT-qPCR), and Western blotting (WB). Next, MC3T3-E1s (pre-osteoblast cells) were differentiated to osteoblast by stimulating the cells with varying AS concentrations. Next, we performed alkaline phosphatase (ALP) staining, RT-qPCR, and WB on these cells. We established an OVX-induced osteoporosis mice model and treated the mice with 20mg/kg of AS. Finally, we extracted the femurs and performed micro-CT scanning, H&E, and TRAP staining. Results AS inhibits the formation of osteoclasts and resorption of bone triggered by RANKL by inhibiting the PI3K/Akt signaling pathway. Furthermore, AS enhances the differentiation of osteoblasts and inhibits bone loss due to OVX in vivo. Conclusion AS inhibits osteoclast production and enhances osteoblast differentiation in mice, thus providing a new therapeutic approach for treating patients with osteoporosis.
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Affiliation(s)
- Jiacheng Sun
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Guoping Cai
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Jinlong Shen
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Pu Cheng
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Jiapeng Zhang
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Dengteng Jiang
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Xianquan Xu
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Fangying Lu
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Lihua Chen
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
| | - Haixiao Chen
- Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, People’s Republic of China
- Bone Development and Metabolism Research Center of Taizhou Hospital, Linhai, Zhejiang Province, People’s Republic of China
- Correspondence: Haixiao Chen; Lihua Chen, Department of Orthopaedics, Taizhou Hospital Affiliated to Wenzhou Medical University, N.150 Ximen Road of Linhai City, Taizhou, Zhejiang Province, People’s Republic of China, Tel +86 15268400288, +86 13757624851, Email ;
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SANCAR B, TALAY GA. Treatment of Apical Periodontitis Induced BRONJ with Endodontic Treatment. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.972890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ), which is one of the serious side effects of bisphosphonates, has an increasing clinical importance due to the widespread use of bisphosphonates in the treatment of many diseases such as osteoporosis, osteopenia, Paget's disease, osteogenesis imperfecta, and multiple myeloma. BRONJ can spontaneously develop in the jawbones. In addition, many factors such as tooth extraction, periodontal diseases, and local trauma can trigger BRONJ. In our case, it was detected that the lesion appearing like BRONJ in the left lower jaw of the 67-year-old female patient with a history of oral bisphosphonate use developed due to apical periodontitis resulting from the tooth numbered 34. Root canal treatment was administered to the relevant tooth of the patient, the fistula tract was closed after this treatment, and as a result of the CBCT examination, it was observed that the enlargement in the necrotic bone area stopped. In addition, the patient's complaints about the relevant tooth disappeared. As a result, endodontic treatment is an effective treatment approach in the treatment of BRONJ developing due to apical periodontitis. In order to avoid the risk of BRONJ, a detailed oral examination should be performed before starting the bisphosphonate treatment, and necessary endodontic, restorative and periodontal treatments should be followed.
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Affiliation(s)
- Bahadır SANCAR
- İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı
| | - Gönen Aras TALAY
- İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalı
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Xian Y, Su Y, Liang J, Long F, Feng X, Xiao Y, Lian H, Xu J, Zhao J, Liu Q, Song F. Oroxylin A reduces osteoclast formation and bone resorption via suppressing RANKL-induced ROS and NFATc1 activation. Biochem Pharmacol 2021; 193:114761. [PMID: 34492273 DOI: 10.1016/j.bcp.2021.114761] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/02/2021] [Accepted: 09/02/2021] [Indexed: 01/15/2023]
Abstract
Excessive bone erosion by osteoclasts is associated with osteoporosis, rheumatoid arthritis, and periprosthetic osteolysis. Targeting osteoclasts may serve as an effective treatment for osteolytic diseases. Although drugs are currently available for the treatment of these diseases, exploring potential anti-osteoclast natural compounds with safe and effective treatment remains needed. Oroxylin A (OA), a natural flavonoid isolated from the root of Scutellaria baicalensis Georgi, has numerous beneficial pharmacological characteristics, including anti-inflammatory and antioxidant activity. However, its effects and mechanisms on osteoclast formation and bone resorption have not yet been clarified. Our research showed that OA attenuated the formation and function of osteoclast induced by RANKL in a time- and concentration-dependent manner without any cytotoxicity. Mechanistically, OA suppressed intracellular reactive oxygen species (ROS) levels through the Nrf2-mediated antioxidant response. Moreover, OA inhibited the activity of NFATc1, the master transcriptional regulator of RANKL-induced osteoclastogenesis. OA exhibited protective effects in mouse models of post-ovariectomy (OVX)- and lipopolysaccharide (LPS)-induced bone loss, in accordance with its in vitro anti-osteoclastogenic effect. Collectively, our findings highlight the potential of OA as a pharmacological agent for the prevention of osteoclast-mediated osteolytic diseases.
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Affiliation(s)
- Yansi Xian
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yuangang Su
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiamin Liang
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Feng Long
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoliang Feng
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yu Xiao
- Medical College of Guangxi University, Nanning, Guangxi, China
| | - Haoyu Lian
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiake Xu
- School of Biomedical Sciences, the University of Western Australia, Perth, Australia
| | - Jinmin Zhao
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China; Orthopaedic Department, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Qian Liu
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China.
| | - Fangming Song
- Guangxi Key Laboratory of Regenerative Medicine, Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, Guangxi, China.
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Katz J, Rotstein I. Prevalence of Periapical Lesions in Patients with Osteoporosis. J Endod 2020; 47:234-238. [PMID: 33130060 DOI: 10.1016/j.joen.2020.10.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/16/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Osteoporosis is a major systemic disease that can significantly deteriorate the quality of life of the affected individuals. It is more common in women, particularly after menopause. Osteoporosis may be associated with alterations in oral health. Treatment of osteoporotic patients mainly involves the administration of bisphosphonates (BPs). Nitrogen-containing BPs are more potent therapeutically and more commonly used. The purpose of this study was to assess the prevalence of periapical lesions in patients with osteoporosis and to evaluate the difference in the prevalence of periapical lesions in patients treated with alendronate and risedronate, 2 nitrogen-containing types of BPs. METHODS Integrated data of hospital patients were used. Data from the corresponding diagnosis codes for osteoporosis and periapical periodontitis were retrieved by searching the appropriate query in the database. The odds ratio (OR) of periapical lesions, its association with osteoporosis, and the use of 2 BP medications were calculated and analyzed statistically. RESULTS Of 1,644,953 hospital patients, 8715 presented with periapical lesions. A total of 42,292 patients were diagnosed with osteoporosis. A total of 754 patients diagnosed with osteoporosis presented with periapical lesions. The prevalence of periapical lesions in patients with osteoporosis was 1.78% compared with 0.52% in the general patient population of the hospital. The OR for the prevalence of periapical lesions in patients with osteoporosis was 3.36 and was statistically significant (P < .0001). Patients with osteoporosis treated with any type of BPs showed a prevalence of periapical lesions in 1.25% of cases compared with 0.52% in the general patient population of the hospital. The difference in the OR was statistically significant (P < .0001). The OR for the presence of periapical lesions in the osteoporosis group treated with BPs was 2.35 compared with 3.52 in the osteoporosis group not treated with BP. The difference in the OR was statistically significant (P < .0001). Patients treated with alendronate showed an OR of 1.6 for the prevalence of periapical lesions, and the difference in the OR was statistically significant (P < .0001). Patients treated with risedronate showed an OR of 1.34 for the prevalence of periapical lesions, and the difference in the OR was not statistically significant (P = .3502). CONCLUSIONS Under the conditions of this study, it appears that the prevalence of periapical lesions is significantly higher in osteoporotic patients. Osteoporotic patients treated with BPs showed a marked reduction in the prevalence of periapical lesions, especially when risedronate was used.
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Affiliation(s)
- Joseph Katz
- Department of Oral Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, Florida
| | - Ilan Rotstein
- Division of Endodontics and Orthodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California.
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Xiao B, Zou Z, Bhandari J, Zhang Y, Yan G. Exposure to diode laser (810nm) affects the bacterial adherence and biofilm formation in a E. faecalis biofilm model. Photodiagnosis Photodyn Ther 2020; 31:101772. [DOI: 10.1016/j.pdpdt.2020.101772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/14/2020] [Accepted: 04/02/2020] [Indexed: 10/24/2022]
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de Miranda Candeiro GT, Bradaschia-Correa V, Gama Vaz SC, Bitu Sousa F, Avelar RL, Gavini G, Silva Costa CP, Carvalho CN. Spontaneous Bisphosphonate-related Osteonecrosis Associated with a Tooth that Had a Necrotic Pulp: A Case Report. IRANIAN ENDODONTIC JOURNAL 2020; 15:188-194. [PMID: 36703802 PMCID: PMC9709851 DOI: 10.22037/iej.v15i3.27849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 01/28/2023]
Abstract
This study reports the endodontic treatment performed in a patient who presented with spontaneous bone exposure in the mandible while using intravenous bisphosphonate medication (Zometa , Novartis Pharmaceuticals Co., Basel, Switzerland). A 63-year-old female patient was referred to a private dental clinic at Fortaleza, Brazil. The patient reported that one year before, she had undergone chemotherapy for the treatment of lung cancer and associated bone metastasis. Among the medications administered was the zolendronic acid, with dosage of 4 mg every 21 days. In the oral exam, the presence of extensive bone exposure was observed in the lingual region near tooth 37. The patient reported severe pain on palpation in the region; in the pulpal sensitivity test with cold stimulus, there was an absence of pain, characteristic of pulp necrosis. Radiographically, no periapical lesion was observed. Thus, endodontic treatment was performed, and instrumentation with Reciproc R25 files in the mesial root canals and R40 in the distal canal was done, alongside with abundant 2.5% sodium hypochlorite irrigation. Interappointment medication with calcium hydroxide was maintained for 15 days. In the second session, there was the spontaneous detachment of the exposed cortical bone fragment. The root canals were filled with gutta-percha and Endosequence BC Sealer cement. After two years, complete tissue repair was observed, and the patient presented with normal periapical tissues and the tooth in masticatory function. It may be concluded that a possible relationship between pulp and periapical infections and osteonecrosis exists in patients who use bisphosphonates.
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Affiliation(s)
| | | | | | - Fabrício Bitu Sousa
- Post Graduation Program in Dental Sciences, University Christus, Fortaleza, Brazil
| | - Rafael Linard Avelar
- Post Graduation Program in Dental Sciences, University Christus, Fortaleza, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Ceci Nunes Carvalho
- Post Graduation Program in Dentistry, CEUMA University, São Luís, Brazil; ,Corresponding author: Ceci Nunes Carvalho, School of Dentistry, CEUMA University, São Luis, Maranhão, Brazil; b Discipline of Dental Materials, School of Dentistry, Federal University of Maranhão, Maranhão, Brazil. E-mail:
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Ajwa N. The role of bisphosphonates in orthodontic tooth movement-A review. J Family Med Prim Care 2019; 8:3783-3788. [PMID: 31879614 PMCID: PMC6924235 DOI: 10.4103/jfmpc.jfmpc_825_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 09/26/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022] Open
Abstract
The present study has reviewed and put insights on the reports and recent literatures confined to the effects of bisphosphonate (BP) medication on orthodontic tooth movement (OTM). Pharmacological anchorage control plays a vital role in orthodontic treatment planning to the required patients. BPs inhibit bone resorption by involving increased activity of mineral adsorption on the bone surfaces where BPs tend to target osteoclasts. The present study reviewed on the latest report and examined cases relating to the impact of BPs in OTM. Clinical implication, chemical formulation, and mode of action of BPs have been discussed. This reviewspecifically focused on various kinds of BPs used in medication for bone adsorption in OTM therapy. Furthermore, it tries to explore the rare adverse and side effects of BPs observed based on the literatures. A systematic literature search was attempted in the Medline database (PubMed) using appropriate keywords, such as orthodontic tooth movement, bisphosphonates, and manual hand look was more overdone. On the basis of reports examined, BP treatments in OTM have posed an increased trend toward the benefit and interfere with osteoclastic resorption. In many cases, they may be advantageous for mooring strategies and encourage long-term planned randomized controlled trials to evaluate conceivable benefits and antagonistic impacts of BP treatments for OTM, before initiating remedial use.
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Affiliation(s)
- Nancy Ajwa
- Department of Preventive Dental Science, Orthodontic Division, Riyadh Elm University, Riyadh, KSA
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12
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Song M. Dental care for patients taking antiresorptive drugs: a literature review. Restor Dent Endod 2019; 44:e42. [PMID: 31799170 PMCID: PMC6875544 DOI: 10.5395/rde.2019.44.e42] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/04/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Antiresorptive drugs (ARDs), such as bisphosphonates or denosumab, that prevent bone resorption are widely used in patients with osteoporosis or with cancer that has metastasized to the bones. Although osteonecrosis of the jaw (ONJ) is a well-documented complication of ARD use, the benefits ARDs outweigh the complication. Thus, research has focused on finding ways to prevent or reduce the risk of developing ONJ. Dentists, as part of a multi-professional team, have a critical role in preventing ONJ. However, many dentists tend to hesitate to provide dental care to patients with ONJ, or tend to think that it is a problem to be dealt with by oral surgeons. This review gives an overview of ARD-related ONJ and provides the guidelines for dental care in patients taking ARDs to lower the risk of developing ONJ.
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Affiliation(s)
- Minju Song
- Department of Conservative Dentistry, College of Dentistry, Dankook University, Cheonan, Korea
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13
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Abstract
Life expectancy has increased as a result of advancements in health care services; thus, maintaining healthy dentition is an important factor in overall health. Furthermore, the growing desire of elderly patients to maintain their teeth has led to an increased need for the performance of complex dental treatment in elderly patients. Root canal therapy is an essential phase of such treatments. Elderly patients may exhibit one or more systemic conditions that require special care, in addition to other changes that occur within the dentition and oral mucosa as a result of aging. These make root canal treatment in elderly patients a great challenge. The aim of this review was to characterize pathologic and physiologic changes in elderly patients that can interfere with root canal treatment procedures, as well as attitudes of elderly patients toward such treatment, guidelines and clinical considerations for management of root canal treatment in elderly patients.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia. E-mail.
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