Prosthodontic care and management of patients with MRONJ from different microbiological backgrounds
Abstract
Medication-related osteonecrosis of the Jaw (MRONJ) is a severe condition of multifactorial origin, with its exact etiological
factors still not fully understood. Besides bisphosphonates, many other drugs are responsible for the development of
this condition. The etiology of MRONJ is not precisely known, but infectious origins are being attributed to greater significance.
Recently, several authors have highlighted the potential role of Actinomyces strains in the disease course.
This publication presents the prosthetic rehabilitation of two MRONJ patients with different microbiological backgrounds
and thus different treatments. One patient received solely surgical therapy, while the other underwent both surgical and
long-term conservative treatment, resulting in recovery for both. Both patients regularly attend follow-up appointments,
show no signs of MRONJ recurrence, and are satisfied with their dental prostheses both functionally and aesthetically.
References
Ali, I. E., & Sumita, Y. (2022). Medication-related osteonecrosis of the jaw: Prosthodontic considerations. The Japanese dental science review, 58, 9–12. https://doi.org/10.1016/j.jdsr.2021.11.005
Bandela, V., Munagapati, B., Karnati, R. K., Venkata, G. R., & Nidudhur, S. R. (2015). Osteoporosis: Its Prosthodontic Considerations - A Review. Journal of clinical and diagnostic research: JCDR, 9(12), ZE01–ZE4. https://doi.org/10.7860/JCDR/2015/14275.6874
Brody A, Scheich B, Dobo-Nagy C: Targeted histological evaluation shows high incidence of actinomyces infection in medication-related osteonecrosis of the jaws. Sci Rep. 2022;12(1):3406. https://doi.org/10.1038/s41598-022-07375-1
Brook I. (2008). Actinomycosis: diagnosis and management. Southern medical journal, 101(10), 1019–1023. https://doi.org/10.1097/SMJ.0b013e3181864c1f
Cerrato A, Zanette G, Boccuto M, Angelini A, Valente M, Bacci C: Actinomyces and MRONJ: A retrospective study and a literature review. J Stomatol Oral Maxillofac Surg. 2021;122(5):499-504. https://doi.org/10.1016/j.jormas.2020.07.012
Di Fede O, Panzarella V, Mauceri R, et al: The Dental Management of Patients at Risk of Medication-Related Osteonecrosis of the Jaw: New Paradigm of Primary Prevention. Biomed Res Int. 2018;2018:2684924. https://doi.org/10.1155/2018/2684924
Fung, P., Bedogni, G., Bedogni, A., Petrie, A., Porter, S., Campisi, G., Bagan, J et al. (2017). Time to onset of bisphosphonate-related osteonecrosis of the jaws: a multicentre retrospective cohort study. Oral diseases, 23(4), 477–483. https://doi.org/10.1111/odi.12632
GeraI., & SzücsN. (2024). Az osteoporosis antirezorptív kezelésének biológiai alapjai és az állcsontok antirezorptív kezelés okozta osteonecrosisa. Fogorvosi Szemle, 117(1), 11-21. https://doi.org/10.33891/FSZ.117.1.11-21
Hansen T, Kunkel M, Kirkpatrick CJ, Weber A: Actinomyces in infected osteoradionecrosis--underestimated?. Hum Pathol. 2006;37(1):61-67. https://doi.org/10.1016/j.humpath.2005.09.018
Karanfilian KM, Valentin MN, Kapila R, Bhate C, Fatahzadeh M, Micali G et al: Cervicofacial actinomycosis. Int J Dermatol 2020;59(10):1185-1190. https://doi.org/10.1111/ijd.14833
Mensch K, Farkas P, Károlyházy K: Életmentő korai diagnózis a fogorvosi székben Diffúz nagy B-sejtes lymphoma a sinus maxillarisban. Fogorvosi Szemle, 2021. 114. évf. 1. sz. 2021. 31–38 https://doi.org/10.33891/FSZ.114.1.31-38
Mensch K, Nagy G, Nagy Á, Bródy A: A szájüreg leggyakoribb bakteriális eredetű kórképeinek jellegzetességei, diagnosztikája és kezelése [Characteristics, diagnosis and treatment of the most common bacterial diseases of the oral cavity]. Orv Hetil. 2019;160(19):739-746 http://dx.doi.org/10.1556/650.2019.31377
Mensch K, Szarka K, Mensch H, Dobai A, Magyar Z, Pacurar M et al: PCR Technique Assisting the Early Diagnosis of Human Papillomavirus A retrospective clinical study. Revista de Chimie, 2018. 69: p. 2781-2787. https://doi.org/10.37358/RC.18.10.6624
Ruggiero, S. L., Dodson, T. B., Aghaloo, T., Carlson, E. R., Ward, B. B., & Kademani, D. (2022). American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws-2022 Update. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 80(5), 920–943. https://doi.org/10.1016/j.joms.2022.02.008
Szentpéteri, S., Restár, L., Németh, Z., & Vaszilkó, M. (2020). A gyógyszer okozta állcsontnekrózis prognózisát befolyásoló faktorok [Prognostic factors of the medication-related osteonecrosis of the jaw]. Orvosi hetilap, 161(8), 283–289. https://doi.org/10.1556/650.2019.31621
Udvardy, E., Redl, P., & Márton, I. (2008). Biszfoszfonát-kezelés során fellépo állcsontnecrosis [Osteonecrosis of the jaw developing during bisphosphonate treatment]. Magyar onkologia, 52(1), 81–87. https://doi.org/10.1556/MOnkol.52.2008.1.12
Veszelyné Kotán, E., Bartha-Lieb, T., Parisek, Z., Meskó, A., Vaszilkó, M., & Hankó, B. (2019). Database analysis of the risk factors of bisphosphonate-related osteonecrosis of the jaw in Hungarian patients. BMJ open, 9(5), e025600. https://doi.org/10.1136/bmjopen-2018-025600
Yarom, N., Shapiro, C. L., Peterson, D. E., Van Poznak, C. H., Bohlke, K., Ruggiero, S. L., Migliorati, C. A., Khan, A., Morrison, A., Anderson, H., Murphy, B. A., Alston-Johnson, D., Mendes, R. A., Beadle, B. M., Jensen, S. B., & Saunders, D. P. (2019). Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 37(25), 2270–2290. https://doi.org/10.1200/JCO.19.01186
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