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Research paper thumbnail of Incidence of osteonecrosis of the jaws in patients over 64 years who have undergone intravenous bisphosphonates therapy. A retrospective study of 149 patients

Medicina Oral Patologia Oral Y Cirugia Bucal, 2016

Research paper thumbnail of El cáncer orofaríngeo

Research paper thumbnail of Osteonecrosis of the jaws in 194 patients who have undergone intravenous bisphosphonate therapy in Spain

Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing... more Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing bisphosphonate therapy and it is modulated by local and systemic factors. The purpose of this article is to determine the prevalence of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described to establish a protocol to reduce the risk of developing ONJ. Material and Methods: We performed a retrospective study on 194 patients treated with IV bisphosponates, analyzing clinical and pathological variables. Results: The prevalence of ONJ was 12.9 %. The most remarkable complication was pain, which was reported by 80% of patients. The average age of the patients undergoing bisphosphonate therapy was 68.91 years. Most of non-diabetic patients did not develop ONJ (92.3%) (p=0.048). During bisphosphonate therapy, 3.1% of patients underwent extractions in the same percentage in the maxilla and in the mandible; all of which, except for one patie...

Research paper thumbnail of Role of microbiota and inflammation in osteonecrosis of the jaw

Background: Describe the presence of Actinomyces in bone biopsies and exudates from patients with... more Background: Describe the presence of Actinomyces in bone biopsies and exudates from patients with ONJ and to determine the degree of inflammation caused by it, evaluating its relationship with clinical/pathological parameters and prognosis as regards evolution of the patient according to the antibiogram for the sample. Material and methods: 28 patients with ONJ were reviewed retrospectively. Wound exudate was submitted to microbiology analyses and antiobiogram. Bone sequestra biopsies were analyzed histopathologically to visualize the Actinomyces colonies. Results: 87.5% of biopsies showed the presence of Actinomyces. The inflammatory response was very variable, ranging from absent to intense but it increases with age (P=0.005). Aerobic bacteria were found almost exclusively in patients with grade I and II ONJ (85%). In contrast, anaerobic bacteria were present in 56% of patients for all three grades of ONJ. The combination of amoxicillin with clavulanic acid showed good sensitivity...

Research paper thumbnail of Osteonecrosis de los maxilares por bifosfonatos

La osteonecrosis por bifosfonatos es una de las mayores complicaciones exclusivas de los huesos m... more La osteonecrosis por bifosfonatos es una de las mayores complicaciones exclusivas de los huesos maxilares derivadas del tratamiento con bifofonatos orales e intravenosos en pacientes con osteoporosis, Enfermedad de Paget o metastasis oseas. EL origen de dicha complicacion es desconocido pero se sabe que estos farmacos interfieren en los procesos de remodelacion osea, y ademas la flora bacteriana es un factor que puede promover su aparicion y tambien retrasar su curacion. El tratamiento conservador pretende controlar el dolor y la infeccion mediante antibioticoperapia y antmicrobianos orales.; y el tratamiento quirurgico, esta reservado para pacientes resistentes al tratamiento conservador o los casos con osteonecrosis muy avanzadas. Actualmente, en los pacientes sin gran compromiso sistemico, se investigan puauas de retirada del farmaco tanto para mejorar la necrosis establecida como para evitar su aparicion. En cualquier caso, ningun tratamiento descrito permite la curacion en la t...

Research paper thumbnail of Osteonecrosis of the jaws in 194 patients who have undergone intravenous bisphosphonate therapy in Spain

Medicina Oral Patología Oral y Cirugia Bucal, 2015

Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing... more Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing bisphosphonate therapy and it is modulated by local and systemic factors. The purpose of this article is to determine the prevalence of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described to establish a protocol to reduce the risk of developing ONJ. Material and Methods: We performed a retrospective study on 194 patients treated with IV bisphosponates, analyzing clinical and pathological variables. Results: The prevalence of ONJ was 12.9 %. The most remarkable complication was pain, which was reported by 80% of patients. The average age of the patients undergoing bisphosphonate therapy was 68.91 years. Most of non-diabetic patients did not develop ONJ (92.3%) (p=0.048). During bisphosphonate therapy, 3.1% of patients underwent extractions in the same percentage in the maxilla and in the mandible; all of which, except for one patient, developed ONJ (p<0.001). In regards to the periodontal state, 94.3% of patients without periodontal problems did not develop ONJ (p=0.001). Almost 50% of the necrosis were located unifocally on the mandible (p<0.001). The number of affected patients and the aggressiveness of the disease increased significantly three years after starting treatment (p<0.001). Conclusions: Etiology still is a controversial issue and we should focus on known risk factors, such as the development of surgical procedures in patients undergoing bisphosphonate therapy, especially in patients who have already started their treatment, a group in which ONJ prevalence increases. Moreover, a bad periodontal state in

Research paper thumbnail of Osteonecrosis of the Jaws. Prevalence, Risk Factors and Role of Microbiota and Inflammation in a Population of Spain

Introduction: The purpose of this article is to determine the prevalence of ONJ in patients who h... more Introduction: The purpose of this article is to determine the prevalence of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described (including Actinomices); indeed, to establish a protocol to reduce the risk of developing ONJ and to evaluate the evolution of the patient according to the sample’s antibiogram. Results: The prevalence of ONJ was 12.9%. Most of the non-diabetic patients did not develop ONJ (92.3%) (p = 0.048). In regards to the periodontal state, 94.3% of patients without periodontal problems did not develop ONJ (p = 0.001). Almost 50% of the necrosis were unifocal and located on the mandible (p < 0.001). The number of affected patients and the aggressiveness of the disease increased significantly three years after starting treatment (p < 0.001). 87.5% of biopsies showed the presence of Actinomyces. The inflammatory response was very variable, ranging from absent to intense but it increased with age (p = 0.005)....

Research paper thumbnail of Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers

Journal of Occupational & Environmental Medicine

Research paper thumbnail of Incidence of osteonecrosis of the jaws in patients over 64 years who have undergone intravenous bisphosphonates therapy. A retrospective study of 149 patients

Medicina Oral Patologia Oral Y Cirugia Bucal, 2016

Research paper thumbnail of El cáncer orofaríngeo

Research paper thumbnail of Osteonecrosis of the jaws in 194 patients who have undergone intravenous bisphosphonate therapy in Spain

Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing... more Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing bisphosphonate therapy and it is modulated by local and systemic factors. The purpose of this article is to determine the prevalence of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described to establish a protocol to reduce the risk of developing ONJ. Material and Methods: We performed a retrospective study on 194 patients treated with IV bisphosponates, analyzing clinical and pathological variables. Results: The prevalence of ONJ was 12.9 %. The most remarkable complication was pain, which was reported by 80% of patients. The average age of the patients undergoing bisphosphonate therapy was 68.91 years. Most of non-diabetic patients did not develop ONJ (92.3%) (p=0.048). During bisphosphonate therapy, 3.1% of patients underwent extractions in the same percentage in the maxilla and in the mandible; all of which, except for one patie...

Research paper thumbnail of Role of microbiota and inflammation in osteonecrosis of the jaw

Background: Describe the presence of Actinomyces in bone biopsies and exudates from patients with... more Background: Describe the presence of Actinomyces in bone biopsies and exudates from patients with ONJ and to determine the degree of inflammation caused by it, evaluating its relationship with clinical/pathological parameters and prognosis as regards evolution of the patient according to the antibiogram for the sample. Material and methods: 28 patients with ONJ were reviewed retrospectively. Wound exudate was submitted to microbiology analyses and antiobiogram. Bone sequestra biopsies were analyzed histopathologically to visualize the Actinomyces colonies. Results: 87.5% of biopsies showed the presence of Actinomyces. The inflammatory response was very variable, ranging from absent to intense but it increases with age (P=0.005). Aerobic bacteria were found almost exclusively in patients with grade I and II ONJ (85%). In contrast, anaerobic bacteria were present in 56% of patients for all three grades of ONJ. The combination of amoxicillin with clavulanic acid showed good sensitivity...

Research paper thumbnail of Osteonecrosis de los maxilares por bifosfonatos

La osteonecrosis por bifosfonatos es una de las mayores complicaciones exclusivas de los huesos m... more La osteonecrosis por bifosfonatos es una de las mayores complicaciones exclusivas de los huesos maxilares derivadas del tratamiento con bifofonatos orales e intravenosos en pacientes con osteoporosis, Enfermedad de Paget o metastasis oseas. EL origen de dicha complicacion es desconocido pero se sabe que estos farmacos interfieren en los procesos de remodelacion osea, y ademas la flora bacteriana es un factor que puede promover su aparicion y tambien retrasar su curacion. El tratamiento conservador pretende controlar el dolor y la infeccion mediante antibioticoperapia y antmicrobianos orales.; y el tratamiento quirurgico, esta reservado para pacientes resistentes al tratamiento conservador o los casos con osteonecrosis muy avanzadas. Actualmente, en los pacientes sin gran compromiso sistemico, se investigan puauas de retirada del farmaco tanto para mejorar la necrosis establecida como para evitar su aparicion. En cualquier caso, ningun tratamiento descrito permite la curacion en la t...

Research paper thumbnail of Osteonecrosis of the jaws in 194 patients who have undergone intravenous bisphosphonate therapy in Spain

Medicina Oral Patología Oral y Cirugia Bucal, 2015

Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing... more Introduction: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing bisphosphonate therapy and it is modulated by local and systemic factors. The purpose of this article is to determine the prevalence of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described to establish a protocol to reduce the risk of developing ONJ. Material and Methods: We performed a retrospective study on 194 patients treated with IV bisphosponates, analyzing clinical and pathological variables. Results: The prevalence of ONJ was 12.9 %. The most remarkable complication was pain, which was reported by 80% of patients. The average age of the patients undergoing bisphosphonate therapy was 68.91 years. Most of non-diabetic patients did not develop ONJ (92.3%) (p=0.048). During bisphosphonate therapy, 3.1% of patients underwent extractions in the same percentage in the maxilla and in the mandible; all of which, except for one patient, developed ONJ (p<0.001). In regards to the periodontal state, 94.3% of patients without periodontal problems did not develop ONJ (p=0.001). Almost 50% of the necrosis were located unifocally on the mandible (p<0.001). The number of affected patients and the aggressiveness of the disease increased significantly three years after starting treatment (p<0.001). Conclusions: Etiology still is a controversial issue and we should focus on known risk factors, such as the development of surgical procedures in patients undergoing bisphosphonate therapy, especially in patients who have already started their treatment, a group in which ONJ prevalence increases. Moreover, a bad periodontal state in

Research paper thumbnail of Osteonecrosis of the Jaws. Prevalence, Risk Factors and Role of Microbiota and Inflammation in a Population of Spain

Introduction: The purpose of this article is to determine the prevalence of ONJ in patients who h... more Introduction: The purpose of this article is to determine the prevalence of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described (including Actinomices); indeed, to establish a protocol to reduce the risk of developing ONJ and to evaluate the evolution of the patient according to the sample’s antibiogram. Results: The prevalence of ONJ was 12.9%. Most of the non-diabetic patients did not develop ONJ (92.3%) (p = 0.048). In regards to the periodontal state, 94.3% of patients without periodontal problems did not develop ONJ (p = 0.001). Almost 50% of the necrosis were unifocal and located on the mandible (p < 0.001). The number of affected patients and the aggressiveness of the disease increased significantly three years after starting treatment (p < 0.001). 87.5% of biopsies showed the presence of Actinomyces. The inflammatory response was very variable, ranging from absent to intense but it increased with age (p = 0.005)....

Research paper thumbnail of Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers

Journal of Occupational & Environmental Medicine