Osteonecrosis relacionada con fármacos (original) (raw)
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OSTEONECROSIS MAXILAR ASOCIADA A MEDICAMENTOS
Aunque la quimiosteonecrosis maxilar se vinculó inicialmente a los pacientes tratados con bisfosfonatos (2003) se ha observado un número creciente de fármacos relacionados con esta patología, como el antineoplásico Bevacizumab en 2008), el antirresortivo Denosumab (primeros casos publicados en 2010) y los empleados en las terapias anti-angiogénicas usadas en terapia oncológica. Por este motivo, en 2014, la Asociación Americana de Cirujanos Orales y Maxilofaciales (AAOMS) recomendó cambiar el nombre de Osteonecrosis Maxilar Asociada a Bifosfonatos (BRONJ, por sus siglas en inglés) por Osteonecrosis Maxilar Asociada a Medicamentos (MRONJ). En monoterapia la pueden producir (en orden decreciente de casos recogidos en VigiBase): denosumab (4133), bevacizumab (209), sunitinib (168), metotrexate (82), sorafenib (23), imatinib (23), pazopanib (21), rituximab (18), axitinib (13), cabozantinib (12), aflibercept (9), lenvatinib (5), regorafenib (2), azacitidina (2) e ipilimumab (1).
Osteonecrosis asociada al uso de bifosfonatos: A propósito de un caso clínico
Revista médica de Chile, 2006
Osteonecrosis associated with the use of biphosphonates: Case report Biphosphonates reduce the risk of skeletal events and are currently part of standards of therapy in myeloma. Recently, zoledronate and pamidronate have been linked to osteonecrosis of the jaw, specially after surgical dental procedures. We report a 84 year-old man with multiple myeloma who developed spontaneous osteonecrosis of both jaws, after 36 months of therapy with zoledronate with a cumulative dose of 136 mg. We discuss the pathogenic mechanisms, and review the recommendations on prevention and management of this new complication for neoplastic patients under prolonged therapy with biphosphonates (Rev
Osteonecrosis asociada al uso de bifosfonatos: A prop�sito de un caso cl�nico
Rev Med Chile, 2006
Osteonecrosis associated with the use of biphosphonates: Case report Biphosphonates reduce the risk of skeletal events and are currently part of standards of therapy in myeloma. Recently, zoledronate and pamidronate have been linked to osteonecrosis of the jaw, specially after surgical dental procedures. We report a 84 year-old man with multiple myeloma who developed spontaneous osteonecrosis of both jaws, after 36 months of therapy with zoledronate with a cumulative dose of 136 mg. We discuss the pathogenic mechanisms, and review the recommendations on prevention and management of this new complication for neoplastic patients under prolonged therapy with biphosphonates (Rev
Revista médica de Chile, 2020
Medication-related osteonecrosis of the jaw is a disease where there is necrotic bone exposed or that can be explored by means of a fistula in the maxillofacial region. It has been associated with the use Biphosphonates and denosumab for osteoporosis. Although its etiology is unclear, it may be related to a decrease in bone turnover produced by these drugs, rendering the bone more prone to generate cell necrosis during invasive dental procedures, especially in the posterior region of the jaw. There is no consensus about the prevention and treatment of this condition. The aim of this paper is to present a review of the literature with the main characteristics of osteonecrosis of the jaws associated with drugs, together with a proposal for prevention and treatment for these patients.
Biphosphonates reduce the risk of skeletal events and are currently part of standards of therapy in myeloma. Recently, zoledronate and pamidronate have been linked to osteonecrosis of the jaw, specially after surgical dental procedures. We report a 84 year-old man with multiple myeloma who developed spontaneous osteonecrosis of both jaws, after 36 months of therapy with zoledronate with a cumulative dose of 136 mg. We discuss the pathogenic mechanisms, and review the recommendations on prevention and management of this new complication for neoplastic patients under prolonged therapy with biphosphonates (Rev Méd Chile 2006; 134: 1161-5). (Recibido el 5 de diciembre, 2005. Aceptado el 24 de marzo, 2006.
Diagnóstico temprano de Osteonecrosis de la mandíbula relacionada a la medicación (MRONJ)
Revista de la Facultad de Odontología, 2020
Medication-related osteonecrosis of the jaw (MRONJ) is an adverse side effect of the use of antiresorptive or antiangiogenic drugs. Once the bone necrosis has progressed and the bone is exposed to the oral cavity, treatment is difficult and may end in resection of the affected bone, resulting in a continuity solution in the affected jaw. It is considere dan irreversible condition, and therefore efforts should be directed at its prevention, both before and after the start of drug therapy. Complementary diagnostic methods such as panoramic radiograph or conebeam computed tomography (CBCT) are very usefull tolos that enable early diagnosis of MRONJ.
Osteonecrosis mandibular asociada a bifosfonatos
Ginecologia Y Obstetricia De Mexico, 2007
Introducción: la osteonecrosis mandibular es un padecimiento relacionado con el tratamiento con bisfosfonatos potentes, con una prevalencia de 1 a 10% en pacientes con cáncer. Objetivo: revisar la bibliografía relacionada con la osteonecrosis mandibular y determinar el estado actual de este padecimiento. Método: con el auxilio del MEDLINE se buscaron y revisaron los artículos publicados sobre el tema hasta el 18 de septiembre de 2007. Se cruzaron las siguientes palabras: bisfosfonatos, alendronato, ácido clodrónico, etidronato, ibandronato, risedronato, osteonecrosis y mandíbula. Se obtuvieron 114 referencias y se seleccionaron las más relevantes. Resultados: la osteonecrosis mandibular se manifiesta de diversas maneras: edema gingival masivo con o sin exposición de hueso necrótico en la cavidad oral, acompañado de dolor intenso o puede ser asintomática. Los síntomas pueden remedar problemas dentales comunes, como: caries o enfermedad periodontal. La osteonecrosis mandibular puede manifestarse espontáneamente o posterior a la extracción de una pieza dentaria. Existen varias teorías para explicarla, pero hasta el momento no hay alguna del todo satisfactoria. El diagnóstico se realiza, principalmente, con base en los antecedentes: edad (séptima década de la vida), aplicación de bisfosfonatos intravenosos, tratamiento prolongado con los mismos, cáncer, extracción dental y quimioterapia. El tratamiento puede ser variable. Conclusión: los bisfosfonatos de potencia elevada y larga duración se relacionan con más riesgo de osteonecrosis mandibular, aunque debe mantenerse una vigilancia estrecha en los prescritos para osteoporosis.