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- Title
Clinical and Histopathological Aspects of MRONJ in Cancer Patients.
- Authors
Ciobanu, George Adrian; Mogoantă, Laurențiu; Camen, Adrian; Ionescu, Mihaela; Vlad, Daniel; Staicu, Ionela Elisabeta; Munteanu, Cristina Maria; Gheorghiță, Mircea Ionuț; Mercuț, Răzvan; Sin, Elena Claudia; Popescu, Sanda Mihaela
- Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a major complication of bisphosphonate treatment in cancer patients, and its etiology is not completely clarified. The study's goal is to find connections between the clinical and histopathological characteristics of osteonecrosis and bisphosphonates in a cohort of cancer patients who had osteonecrosis treated surgically. The retrospective study includes 51 patients of both sexes, aged 46 to 85 years, who underwent surgical treatment for MRONJ in two oral and maxillofacial surgery clinics (Craiova and Constanța). Demographic, clinical, and imaging data from the records of patients with osteonecrosis were analyzed. The surgical treatment removed the necrotic bone, and the harvested fragments were analyzed from a histopathological perspective. The histopathological examination data were evaluated and statistically processed to look for viable bone, granulation tissue, bacterial colonies, and inflammatory infiltrate. In the study groups, MRONJ was found particularly in the posterior regions of the mandible. Tooth extraction, but also periapical or periodontal infections, represented the trigger factors in most of the cases. The surgical therapy consisted of sequestrectomy or bone resection, and the histopathological examination of the fragments revealed osteonecrosis-specific features, such as the lack of bone cells, the development of an inflammatory infiltrate, and the existence of bacterial colonies. MRONJ in cancer patients receiving zoledronic acid is a severe complication that significantly lowers quality of life. Since these patients are not usually monitored by the dentist, they are identified in advanced stages of MRONJ. For these patients, thorough dental monitoring could reduce the incidence of osteonecrosis and its related complications.
- Subjects
CANCER patients; DENTAL extraction; HISTOPATHOLOGY; MAXILLOFACIAL surgery; BACTERIAL colonies; GRANULATION tissue; SURGICAL clinics; MANDIBULAR fractures; PERIAPICAL diseases
- Publication
Journal of Clinical Medicine, 2023, Vol 12, Issue 10, p3383
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm12103383