Salvatore Ruggiero - Academia.edu (original) (raw)

Papers by Salvatore Ruggiero

Research paper thumbnail of Comprehensive Review of Bisphosphonate Therapy: Implications for the Oral and Maxillofacial Surgery Patient INTRODUCTION

J Oral Maxillofac Surg, 2009

Research paper thumbnail of Bisphosphonate-associated osteonecrosis of the jaw : Report of a task force of the american society for bone and mineral research

Journal of Bone and Mineral Research the Official Journal of the American Society For Bone and Mineral Research, Oct 1, 2007

Research paper thumbnail of Bisphosphonate complications including osteonecrosis of the jaw

Hematology / the Education Program of the American Society of Hematology. American Society of Hematology. Education Program, 2006

Bisphosphonate therapy has been incorporated in the standard management of patients with multiple... more Bisphosphonate therapy has been incorporated in the standard management of patients with multiple myeloma-related bony disease. Although their efficacy in reducing skeletal related events is important in the supportive management of the myeloma patient, post-marketing experience with this class of agents, particularly the more potent intravenous agents pamidronate and zoledronic acid, have raised cautionary notes regarding the potential side effects of these agents. The focus of this session is to review the risk factors, incidence, prevention strategies and management of bisphosphonate-related osteonecrosis of the jaw. In addition, pathophysiology, incidence and monitoring for renal dysfunction during chronic therapy with these agents are reviewed.

Research paper thumbnail of EXPOSED BONE IN BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS MAY BE INDUCED AND MAINTAINED BY LOCALIZED MICROBIAL BIOFILM OSTEOMYELITIS Reply

Journal of Oral and Maxillofacial Surgery

Research paper thumbnail of Osteonecrosis of the jaw: Recent clinical and preclinical advances

Research paper thumbnail of Bisphosphonate osteonecrosis of the jaw: A historical and contemporary review

The Surgeon, 2012

Maxilla Dentistry a b s t r a c t

Research paper thumbnail of Compromised osseous healing of dental extraction sites in zoledronic acid-treated dogs

Osteoporosis International, 2011

PURPOSE-The goal of this study was to document how treatment with a bisphosphonate affects the bo... more PURPOSE-The goal of this study was to document how treatment with a bisphosphonate affects the bone tissue following dental extraction.

Research paper thumbnail of Comprehensive Review of Bisphosphonate Therapy: Implications for the Oral and Maxillofacial Surgery Patient

Journal of Oral and Maxillofacial Surgery, 2009

Research paper thumbnail of Absence of Exposed Bone Following Dental Extraction in Beagle Dogs Treated With 9 Months of High-Dose Zoledronic Acid Combined With Dexamethasone

Journal of Oral and Maxillofacial Surgery, 2013

Factors contributing to osteonecrosis of the jaw with anti-remodeling drug treatment are unclear.... more Factors contributing to osteonecrosis of the jaw with anti-remodeling drug treatment are unclear. Epidemiologic and experimental studies have suggested the combination of bisphosphonates and dexamethasone results in osteonecrosis of the jaw more often than either agent alone. The goal of this study was to assess the combination of these 2 drugs in a large animal model previously shown to be susceptible to exposed bone in the oral cavity when treated with bisphosphonates. Skeletally mature beagle dogs were untreated controls or treated with zoledronic acid (ZOL), dexamethasone (DEX), or ZOL plus DEX. ZOL and DEX were given at doses based on those used in humans. All animals underwent single molar extraction at 7 and 8 months after the start of the study. Extraction sites were obtained at month 9 for assessment of osseous healing using micro-computed tomography and histology. No animals were observed to have exposed bone after dental extraction, yet 1 animal treated with ZOL and 1 treated with ZOL plus DEX had severely disrupted extraction sites as viewed by computed tomography and histology. These 2 animals had an intense periosteal reaction that was less obvious but still present in all ZOL-treated animals and absent from untreated animals. There was no significant difference in bone volume within the socket among groups at 4 or 8 weeks after healing, yet the ratio of surface to volume was significantly higher in animals treated with ZOL plus DEX at 8 weeks compared with control animals. These findings suggest a more complex pathophysiology to osteonecrosis of the jaw than is implied by previous epidemiologic studies and those in rodents and raise questions about the potential role of DEX in its etiology.

Research paper thumbnail of Trismus and preauricular swelling in a 20-year-old black woman

Journal of Oral and Maxillofacial Surgery, 1996

A 22-year-old Haitian woman was referred to our institution with a 6-week history of trismus and ... more A 22-year-old Haitian woman was referred to our institution with a 6-week history of trismus and preauricular swelling. The patient had initially presented to a dentist after experiencing pain and "stiffness" of her jaw on the left side. A diagnosis of myofascial pain syndrome was made, and the patient was treated with a soft diet and a nonsteroidal antiinflammatory agent. However, over the course of the next 3 weeks the pain and trismus progressively worsened and was now associated with a left preauricular swelling. The patient was referred to an otolaryngologist, who made the presumptive diagnosis of acute parotitis and placed the patient on a first generation cephalosporin. During the following 2 weeks, the left facial swelling and pain worsened significantly despite her compliance wilh the antibiotic regimen. At that time, she presented to our institution for further evaluation.

Research paper thumbnail of Lack of Correlation Between Duration of Osteonecrosis of the Jaw and Sequestra Tissue Morphology: What It Tells Us About the Condition and What It Means for Future Studies

Journal of Oral and Maxillofacial Surgery, 2010

An increasing number of studies have begun to investigate properties of tissue obtained from pati... more An increasing number of studies have begun to investigate properties of tissue obtained from patients with osteonecrosis of the jaw (ONJ). Due to the relatively low incidence of ONJ, these studies necessitate the use of specimens from patients who have had ONJ for various durations. The goal of this study was to determine if properties, specifically bone morphology assessed by micro-computed tomography (micro-CT), were influenced by the duration of ONJ. Sequestra from 31 patients with confirmed ONJ for between 3 weeks and 42 months prior to obtaining the tissue were scanned using micro-CT to determine bone volume/tissue volume (BV/TV) and bone surface/volume (BS/TV). There was no significant correlation between the sequestra bone morphology (either BV/TV or BS/ TV) and the duration of ONJ. We interpret this as evidence that studies should not be concerned about assessing tissue properties from patients that have had ONJ for different durations. Furthermore, the lack of difference in morphology with continued duration of ONJ suggests that the majority of changes to the bone tissue occur early on in the disease progression.

Research paper thumbnail of Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction of Risk Using Serum CTX Testing, Prevention, and Treatment

Journal of Oral and Maxillofacial Surgery, 2007

Purpose: To assess the risk and time course of oral bisphosphonate-induced osteonecrosis of the j... more Purpose: To assess the risk and time course of oral bisphosphonate-induced osteonecrosis of the jaws.

Research paper thumbnail of Higher Bone Matrix Density Exists in Only a Subset of Patients With Bisphosphonate-Related Osteonecrosis of the Jaw

Journal of Oral and Maxillofacial Surgery, 2009

Purpose: Because few treatment options exist for bisphosphonate-related osteonecrosis of the jaw ... more Purpose: Because few treatment options exist for bisphosphonate-related osteonecrosis of the jaw (BRONJ), developing methods of early detection and prevention is vital. Computed tomography could represent a useful tool for early detection of BRONJ, yet its effectiveness would necessitate changes in tissue density. The aim of this study was to quantify bone matrix density of tissue from patients with BRONJ. Patients and Methods: Bone samples from 13 patients with confirmed BRONJ were scanned by use of high-resolution micro-computed tomography. Mean density and density distribution were assessed and compared with mandible samples from cadaveric controls (n ϭ 8; age range, 43-94 years). Results: The bone matrix in BRONJ samples had a significantly higher mean density (ϩ8.5%, P ϭ .01) compared with cadaveric samples. The higher density in BRONJ tissue was evident in a clear shift in the tissue density profile. In controls, less than 5% of the tissue had a density above the median gray-scale value, whereas on average, BRONJ tissue had approximately 15% of the tissue density in this range. By use of z score analyses of mean density values, a large degree of heterogeneity is evident among BRONJ specimens, with some samples having z scores of 0 and others having z scores well above 6 compared with controls. Conclusions: On the basis of these findings, higher tissue density appears to manifest in only a subset of BRONJ patients, suggesting that density may have limitations as a biomarker for early detection of this condition.

Research paper thumbnail of Metastatic Cancer Identified in Osteonecrosis Specimens of the Jaws in Patients Receiving Intravenous Bisphosphonate Medications

Journal of Oral and Maxillofacial Surgery, 2013

The aim of the present study was to investigate the microscopic presence of metastatic cancer in ... more The aim of the present study was to investigate the microscopic presence of metastatic cancer in jaw specimens clinically and histologically diagnosed as having osteonecrosis in patients receiving intravenous bisphosphonate medications. A retrospective cohort multicenter study was designed. Patients from the University of Tennessee Medical Center, New York University Medical Center, and New York Center for Orthognathic and Maxillofacial Surgery were enrolled who had been treated with intravenous bisphosphonate medications for an underlying diagnosis of cancer and who had been clinically diagnosed with bisphosphonate-related osteonecrosis of the jaws (BRONJ). The institutional review boards approved the present study. The primary predictor variable was the clinical presence of BRONJ. The primary outcome variable was the microscopic presence of metastatic cancer in the osteonecrotic jaw specimens. A total of 744 sites of BRONJ were clinically diagnosed. Of these sites, 552 (74%) were diagnosed in patients who had received intravenous bisphosphonate medications. Of these 552 sites, 357 (65%) underwent microscopic evaluation through biopsy, sequestrectomy, or resection with curative intent. Of the 357 sites of BRONJ subjected to microscopic analysis, 19 (5.3%) sites were diagnosed with 20 cancers in 16 patients. Albeit rare, the presence of cancer in a BRONJ specimen represents 1 explanation for the development of osteonecrosis in patients exposed to intravenous bisphosphonate medications in whom a clinical diagnosis of BRONJ has been applied. Additional molecular information is needed to provide an explanation for this observation.

Research paper thumbnail of Osteonecrosis of the Jaws and Bisphosphonate Therapy

Journal of Dental Research, 2007

Bisphosphonates are a class of agents used to treat osteoporosis and malignant bone metastases. T... more Bisphosphonates are a class of agents used to treat osteoporosis and malignant bone metastases. The efficacy of these agents in treating and preventing the significant skeletal complications associated with these conditions has had a major positive impact for patients and is responsible for their widespread use in medicine. Despite these benefits, osteonecrosis of the jaws has recently emerged as a significant complication in a subset of patients receiving these drugs. Based on a growing number of case reports and institutional reviews, bisphosphonate therapy may cause exposed and necrotic bone that is isolated to the jaw. This complication usually presents following simple dento-alveolar surgery, and can cause a significant adverse effect on the quality of life for most patients. The pathogenesis for this complication appears to be related to the profound inhibition of osteoclast function and bone remodeling.

Research paper thumbnail of Case report: Noonan-like multiple central giant cell granuloma syndrome

Pediatric Dentistry, 2012

The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 yea... more The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 years old born with Noonan-like central giant cell syndrome and unrelated common variable immune deficiency; provide information on the dental management of patients with Noonan's syndrome; and present a brief discussion of the recent associated genetic findings. A review of the common features of Noonan syndrome and Noonan-like central giant cell syndrome is also provided.

Research paper thumbnail of American Association of Oral and Maxillofacial Surgeons Position Paper on Bisphosphonate-Related Osteonecrosis of the Jaws—2009 Update

Journal of Oral and Maxillofacial Surgery Official Journal of the American Association of Oral and Maxillofacial Surgeons, Jan 5, 2009

Research paper thumbnail of Response to Comments on “Diagnosis and Management of Osteoporosis of the Jaw: A Systematic Review and International Consensus”

Journal of Bone and Mineral Research, 2015

Research paper thumbnail of Case report: Noonan-like multiple central giant cell granuloma syndrome

Pediatric dentistry

The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 yea... more The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 years old born with Noonan-like central giant cell syndrome and unrelated common variable immune deficiency; provide information on the dental management of patients with Noonan's syndrome; and present a brief discussion of the recent associated genetic findings. A review of the common features of Noonan syndrome and Noonan-like central giant cell syndrome is also provided.

Research paper thumbnail of American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw - 2009 update

Australian endodontic journal : the journal of the Australian Society of Endodontology Inc, 2009

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) adversely affects the quality of life, pr... more Bisphosphonate-related osteonecrosis of the jaw (BRONJ) adversely affects the quality of life, producing significant morbidity in afflicted patients. Strategies for management of patients with or at risk for BRONJ were set forth in the American Association of Oral and ...

Research paper thumbnail of Comprehensive Review of Bisphosphonate Therapy: Implications for the Oral and Maxillofacial Surgery Patient INTRODUCTION

J Oral Maxillofac Surg, 2009

Research paper thumbnail of Bisphosphonate-associated osteonecrosis of the jaw : Report of a task force of the american society for bone and mineral research

Journal of Bone and Mineral Research the Official Journal of the American Society For Bone and Mineral Research, Oct 1, 2007

Research paper thumbnail of Bisphosphonate complications including osteonecrosis of the jaw

Hematology / the Education Program of the American Society of Hematology. American Society of Hematology. Education Program, 2006

Bisphosphonate therapy has been incorporated in the standard management of patients with multiple... more Bisphosphonate therapy has been incorporated in the standard management of patients with multiple myeloma-related bony disease. Although their efficacy in reducing skeletal related events is important in the supportive management of the myeloma patient, post-marketing experience with this class of agents, particularly the more potent intravenous agents pamidronate and zoledronic acid, have raised cautionary notes regarding the potential side effects of these agents. The focus of this session is to review the risk factors, incidence, prevention strategies and management of bisphosphonate-related osteonecrosis of the jaw. In addition, pathophysiology, incidence and monitoring for renal dysfunction during chronic therapy with these agents are reviewed.

Research paper thumbnail of EXPOSED BONE IN BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS MAY BE INDUCED AND MAINTAINED BY LOCALIZED MICROBIAL BIOFILM OSTEOMYELITIS Reply

Journal of Oral and Maxillofacial Surgery

Research paper thumbnail of Osteonecrosis of the jaw: Recent clinical and preclinical advances

Research paper thumbnail of Bisphosphonate osteonecrosis of the jaw: A historical and contemporary review

The Surgeon, 2012

Maxilla Dentistry a b s t r a c t

Research paper thumbnail of Compromised osseous healing of dental extraction sites in zoledronic acid-treated dogs

Osteoporosis International, 2011

PURPOSE-The goal of this study was to document how treatment with a bisphosphonate affects the bo... more PURPOSE-The goal of this study was to document how treatment with a bisphosphonate affects the bone tissue following dental extraction.

Research paper thumbnail of Comprehensive Review of Bisphosphonate Therapy: Implications for the Oral and Maxillofacial Surgery Patient

Journal of Oral and Maxillofacial Surgery, 2009

Research paper thumbnail of Absence of Exposed Bone Following Dental Extraction in Beagle Dogs Treated With 9 Months of High-Dose Zoledronic Acid Combined With Dexamethasone

Journal of Oral and Maxillofacial Surgery, 2013

Factors contributing to osteonecrosis of the jaw with anti-remodeling drug treatment are unclear.... more Factors contributing to osteonecrosis of the jaw with anti-remodeling drug treatment are unclear. Epidemiologic and experimental studies have suggested the combination of bisphosphonates and dexamethasone results in osteonecrosis of the jaw more often than either agent alone. The goal of this study was to assess the combination of these 2 drugs in a large animal model previously shown to be susceptible to exposed bone in the oral cavity when treated with bisphosphonates. Skeletally mature beagle dogs were untreated controls or treated with zoledronic acid (ZOL), dexamethasone (DEX), or ZOL plus DEX. ZOL and DEX were given at doses based on those used in humans. All animals underwent single molar extraction at 7 and 8 months after the start of the study. Extraction sites were obtained at month 9 for assessment of osseous healing using micro-computed tomography and histology. No animals were observed to have exposed bone after dental extraction, yet 1 animal treated with ZOL and 1 treated with ZOL plus DEX had severely disrupted extraction sites as viewed by computed tomography and histology. These 2 animals had an intense periosteal reaction that was less obvious but still present in all ZOL-treated animals and absent from untreated animals. There was no significant difference in bone volume within the socket among groups at 4 or 8 weeks after healing, yet the ratio of surface to volume was significantly higher in animals treated with ZOL plus DEX at 8 weeks compared with control animals. These findings suggest a more complex pathophysiology to osteonecrosis of the jaw than is implied by previous epidemiologic studies and those in rodents and raise questions about the potential role of DEX in its etiology.

Research paper thumbnail of Trismus and preauricular swelling in a 20-year-old black woman

Journal of Oral and Maxillofacial Surgery, 1996

A 22-year-old Haitian woman was referred to our institution with a 6-week history of trismus and ... more A 22-year-old Haitian woman was referred to our institution with a 6-week history of trismus and preauricular swelling. The patient had initially presented to a dentist after experiencing pain and "stiffness" of her jaw on the left side. A diagnosis of myofascial pain syndrome was made, and the patient was treated with a soft diet and a nonsteroidal antiinflammatory agent. However, over the course of the next 3 weeks the pain and trismus progressively worsened and was now associated with a left preauricular swelling. The patient was referred to an otolaryngologist, who made the presumptive diagnosis of acute parotitis and placed the patient on a first generation cephalosporin. During the following 2 weeks, the left facial swelling and pain worsened significantly despite her compliance wilh the antibiotic regimen. At that time, she presented to our institution for further evaluation.

Research paper thumbnail of Lack of Correlation Between Duration of Osteonecrosis of the Jaw and Sequestra Tissue Morphology: What It Tells Us About the Condition and What It Means for Future Studies

Journal of Oral and Maxillofacial Surgery, 2010

An increasing number of studies have begun to investigate properties of tissue obtained from pati... more An increasing number of studies have begun to investigate properties of tissue obtained from patients with osteonecrosis of the jaw (ONJ). Due to the relatively low incidence of ONJ, these studies necessitate the use of specimens from patients who have had ONJ for various durations. The goal of this study was to determine if properties, specifically bone morphology assessed by micro-computed tomography (micro-CT), were influenced by the duration of ONJ. Sequestra from 31 patients with confirmed ONJ for between 3 weeks and 42 months prior to obtaining the tissue were scanned using micro-CT to determine bone volume/tissue volume (BV/TV) and bone surface/volume (BS/TV). There was no significant correlation between the sequestra bone morphology (either BV/TV or BS/ TV) and the duration of ONJ. We interpret this as evidence that studies should not be concerned about assessing tissue properties from patients that have had ONJ for different durations. Furthermore, the lack of difference in morphology with continued duration of ONJ suggests that the majority of changes to the bone tissue occur early on in the disease progression.

Research paper thumbnail of Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction of Risk Using Serum CTX Testing, Prevention, and Treatment

Journal of Oral and Maxillofacial Surgery, 2007

Purpose: To assess the risk and time course of oral bisphosphonate-induced osteonecrosis of the j... more Purpose: To assess the risk and time course of oral bisphosphonate-induced osteonecrosis of the jaws.

Research paper thumbnail of Higher Bone Matrix Density Exists in Only a Subset of Patients With Bisphosphonate-Related Osteonecrosis of the Jaw

Journal of Oral and Maxillofacial Surgery, 2009

Purpose: Because few treatment options exist for bisphosphonate-related osteonecrosis of the jaw ... more Purpose: Because few treatment options exist for bisphosphonate-related osteonecrosis of the jaw (BRONJ), developing methods of early detection and prevention is vital. Computed tomography could represent a useful tool for early detection of BRONJ, yet its effectiveness would necessitate changes in tissue density. The aim of this study was to quantify bone matrix density of tissue from patients with BRONJ. Patients and Methods: Bone samples from 13 patients with confirmed BRONJ were scanned by use of high-resolution micro-computed tomography. Mean density and density distribution were assessed and compared with mandible samples from cadaveric controls (n ϭ 8; age range, 43-94 years). Results: The bone matrix in BRONJ samples had a significantly higher mean density (ϩ8.5%, P ϭ .01) compared with cadaveric samples. The higher density in BRONJ tissue was evident in a clear shift in the tissue density profile. In controls, less than 5% of the tissue had a density above the median gray-scale value, whereas on average, BRONJ tissue had approximately 15% of the tissue density in this range. By use of z score analyses of mean density values, a large degree of heterogeneity is evident among BRONJ specimens, with some samples having z scores of 0 and others having z scores well above 6 compared with controls. Conclusions: On the basis of these findings, higher tissue density appears to manifest in only a subset of BRONJ patients, suggesting that density may have limitations as a biomarker for early detection of this condition.

Research paper thumbnail of Metastatic Cancer Identified in Osteonecrosis Specimens of the Jaws in Patients Receiving Intravenous Bisphosphonate Medications

Journal of Oral and Maxillofacial Surgery, 2013

The aim of the present study was to investigate the microscopic presence of metastatic cancer in ... more The aim of the present study was to investigate the microscopic presence of metastatic cancer in jaw specimens clinically and histologically diagnosed as having osteonecrosis in patients receiving intravenous bisphosphonate medications. A retrospective cohort multicenter study was designed. Patients from the University of Tennessee Medical Center, New York University Medical Center, and New York Center for Orthognathic and Maxillofacial Surgery were enrolled who had been treated with intravenous bisphosphonate medications for an underlying diagnosis of cancer and who had been clinically diagnosed with bisphosphonate-related osteonecrosis of the jaws (BRONJ). The institutional review boards approved the present study. The primary predictor variable was the clinical presence of BRONJ. The primary outcome variable was the microscopic presence of metastatic cancer in the osteonecrotic jaw specimens. A total of 744 sites of BRONJ were clinically diagnosed. Of these sites, 552 (74%) were diagnosed in patients who had received intravenous bisphosphonate medications. Of these 552 sites, 357 (65%) underwent microscopic evaluation through biopsy, sequestrectomy, or resection with curative intent. Of the 357 sites of BRONJ subjected to microscopic analysis, 19 (5.3%) sites were diagnosed with 20 cancers in 16 patients. Albeit rare, the presence of cancer in a BRONJ specimen represents 1 explanation for the development of osteonecrosis in patients exposed to intravenous bisphosphonate medications in whom a clinical diagnosis of BRONJ has been applied. Additional molecular information is needed to provide an explanation for this observation.

Research paper thumbnail of Osteonecrosis of the Jaws and Bisphosphonate Therapy

Journal of Dental Research, 2007

Bisphosphonates are a class of agents used to treat osteoporosis and malignant bone metastases. T... more Bisphosphonates are a class of agents used to treat osteoporosis and malignant bone metastases. The efficacy of these agents in treating and preventing the significant skeletal complications associated with these conditions has had a major positive impact for patients and is responsible for their widespread use in medicine. Despite these benefits, osteonecrosis of the jaws has recently emerged as a significant complication in a subset of patients receiving these drugs. Based on a growing number of case reports and institutional reviews, bisphosphonate therapy may cause exposed and necrotic bone that is isolated to the jaw. This complication usually presents following simple dento-alveolar surgery, and can cause a significant adverse effect on the quality of life for most patients. The pathogenesis for this complication appears to be related to the profound inhibition of osteoclast function and bone remodeling.

Research paper thumbnail of Case report: Noonan-like multiple central giant cell granuloma syndrome

Pediatric Dentistry, 2012

The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 yea... more The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 years old born with Noonan-like central giant cell syndrome and unrelated common variable immune deficiency; provide information on the dental management of patients with Noonan's syndrome; and present a brief discussion of the recent associated genetic findings. A review of the common features of Noonan syndrome and Noonan-like central giant cell syndrome is also provided.

Research paper thumbnail of American Association of Oral and Maxillofacial Surgeons Position Paper on Bisphosphonate-Related Osteonecrosis of the Jaws—2009 Update

Journal of Oral and Maxillofacial Surgery Official Journal of the American Association of Oral and Maxillofacial Surgeons, Jan 5, 2009

Research paper thumbnail of Response to Comments on “Diagnosis and Management of Osteoporosis of the Jaw: A Systematic Review and International Consensus”

Journal of Bone and Mineral Research, 2015

Research paper thumbnail of Case report: Noonan-like multiple central giant cell granuloma syndrome

Pediatric dentistry

The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 yea... more The purpose of this report was to: summarize the care of a child between the ages of 12 to 16 years old born with Noonan-like central giant cell syndrome and unrelated common variable immune deficiency; provide information on the dental management of patients with Noonan's syndrome; and present a brief discussion of the recent associated genetic findings. A review of the common features of Noonan syndrome and Noonan-like central giant cell syndrome is also provided.

Research paper thumbnail of American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw - 2009 update

Australian endodontic journal : the journal of the Australian Society of Endodontology Inc, 2009

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) adversely affects the quality of life, pr... more Bisphosphonate-related osteonecrosis of the jaw (BRONJ) adversely affects the quality of life, producing significant morbidity in afflicted patients. Strategies for management of patients with or at risk for BRONJ were set forth in the American Association of Oral and ...