Bisphosphonates are drugs used in treatment of different pathological conditions that affect bones, such as osteoporosis, metastatic bone disease, Paget disease and osteogenesis imperfecta, etc. The aim of the study is to present epidemiological, radiological, clinical, histopathological data and treatment overview of patients with BRONJ in Serbia and Montenegro. From year 2009 to 2012 at the Clinic for Maxillofacial surgery – Faculty of Dentistry, University of Belgrade and Podgorica 9 patients were referred to Clinics due to BRONJ, as non-healing wound in the jaw after tooth extraction. Among them, 8 were oncological (two patients with breast carcinoma (22.2%), three patients with prostate carcinoma (33.3%), two multiple myeloma patients (22.2%) and one patient with MTC (11.1%)) and one suffering from osteoporosis (11.1%), which underwent BPs therapy. Sex, age, underlying diagnosis, type of BPs therapy, dosage, duration and way of administration, additional therapy, location of osteonecrosis, clinical symptoms and dental extraction were analyzed parameters (age range (from 37 to 84 years); male to female ratio was (6:3). Obtained data showed that 8 of 9 our patients received Zometa (88.9%) (Zoledronic acid), except one woman (11.1%) who received Bonviva (Ibandronic acid). Female patient who received Bonviva was the only patient that had no malignancy, and received bisphosphonates orally because of osteoporosis. The time passed between periods of extraction to the period when signs of bone necrosis were observed ranged from 0 to 5 months. Radiographic findings displayed either radiolucent osteolytic zones, or superficial bone defects, that were consonant with bone necrosis. Histological examination excluded malignancy. We performed treatment protocol according to the AAOMS recommendations 2009. In out of 5 patients (56%) we achieved complete healing of the intraoral defect and recovery. Other 4 patients (44%) were refractory to the applied treatment. As not so rare disease, BRONJ should not be overlooked in differential diagnosis of oral lesions.
Epidemiological, clinical, histological, radiological and treatment overview of bronj cases from territory of central serbia and montenegro
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