Death of bone tissue due to interruption of the blood supply
POPULARITY
9 episodes with osteonecrosis
3 episodes with osteonecrosis
2 episodes with osteonecrosis
2 episodes with osteonecrosis
2 episodes with osteonecrosis
3 episodes with osteonecrosis
2 episodes with osteonecrosis
Hoại tử xương hàm (OsteoNecrosis of the Jaws - ONJ) là một biến chứng nghiêm trọng liên quan việc sử dụng bisphosphonate, một loại thuốc thường được kê đơn để điều trị loãng xương và các bệnh lý về xương khác.
Are you confident in managing patients on bisphosphonates or biologics? Which medications increase the risk of medication-related osteonecrosis of the jaw (MRONJ)? How do you decide when to extract a tooth and when to refer to a specialist? In this episode, Jaz is joined by oral surgery consultant Dr. Pippa Cullingham to explore the complexities of MRONJ. They break down the key risk factors, share expert advice on when to proceed with extractions, and discuss the latest guidelines for managing patients at risk. They also discuss the importance of early assessment - by identifying at-risk teeth early, you can help prevent serious complications and ensure the best outcome for your patients. https://youtu.be/KnQoI8Z-FhM Watch PDP215 on Youtube Protrusive Dental Pearl: it is so important to assess patients before they start taking high-risk medications like bisphosphonates or biologics, using radiographs to identify potential issues. Extractions should ideally be done before medication starts to avoid complications, as MRONJ risk increases once treatment begins. Key Takeaways: Medication-related osteonecrosis of the jaw concerns medications other than bisphosphonates. Risk assessment is crucial when considering dental extractions for patients on certain medications. Guidelines from the Scottish Dental Clinical Effectiveness Partnership are valuable resources for dentists. Higher-risk patients require careful management and communication with their medical teams. Denosumab has a different risk profile compared to bisphosphonates. Patients on long-term bisphosphonates may still have risks even after stopping the medication. Dentists should feel empowered to manage certain extractions in primary care with proper guidance. The decision to extract a tooth should weigh the risks and benefits for the patient. Always assess the patient's risk before extraction. Eight weeks is a critical time for assessing healing. Antibiotics are not recommended for preventing MRONJ in the UK. Radiotherapy history significantly impacts extraction risk. Referral to specialists may be necessary for high-risk patients. Highlights of this episode: 02:15 Protrusive Dental Pearl 03:52 Interview with Dr. Pippa Cullingham: Insights and Experiences 06:40 Medications and Their Risks 10:02 MRONJ: Incidence and Prevalence 13:13 Biologics and other medications 14:19 Guidelines and Best Practices 17:22 Managing High-Risk Patients 25:03 Prophylactic Antibiotics 26:55 Risk Assessment 28:47 Radiotherapy & ORN Risk 31:49 Tips and Key Takeaways 33:32 New Medications & Prevention Strategies For the best approach to managing MRONJ, check the SDCEP Guidelines and the American White Paper. This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance. This episode meets GDC Outcomes B and C. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Diagnosis, management and treatment of oral pathologies) Dentists will be able to - 1. Be aware of the medications that increase the risk of MRONJ. 2. Learn how to assess the risk of MRONJ in patients, particularly before starting high-risk medications. 3. Understand when to proceed with extractions and when to refer patients to specialists for management. If you liked this episode, check out PDP206 - White Patches
In this episode, we review the high-yield topic of Hip Osteonecrosis from the Recon section. Follow Orthobullets on Social Media: Facebook Instagram Twitter LinkedIn YouTube
In today's episode of Breast Cancer Conversations, we dive deep into oral health! Before undergoing cancer treatment, it is crucial for individuals to prioritize their dental health. This is because cancer treatments, such as chemotherapy, can have significant effects on oral health, specifically how bisphosphonates may lead to Osteonecrosis of the Jaw (ONJ). In this podcast episode, we discuss the importance of visiting a dentist and dental hygienist before starting cancer treatment to achieve optimal oral hygiene. Topics Covered in this Episode: Bisphosphonates and dental health.Dental health considerations before cancer treatment.Oral health during cancer treatment.Understanding dental and medical coverage.Bisphosphonate-induced osteonecrosis of the jaw.Dental complications with bisphosphonates.Osteonecrosis symptoms and diagnosis.Nerve treatment during surgery.+++++++++++++++++++++Attend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/events+++++++++++++++++++++SurvivingBreastCancer.org's Mission: To empower those diagnosed with breast cancer and their families from day one and beyond. About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.+++++++++++++++++++++Follow us on InstagramLaura and Will: https://www.instagram.com/laura_and_will/SurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Support the show
Dr. Daniel Meara discusses risk factors of medication-related osteonecrosis of the jaw (MRONJ), a rare but serious disease that can affect the upper or lower jaw in a person exposed to certain medications.
Drs. Tara Aghaloo and Sal Ruggiero discuss Medication-related Osteonecrosis of the Jaw (MRONJ) and the updated AAOMS position paper published in the Journal of Oral and Maxillofacial Surgery in 2022.
Osteonecrosis of the jaws is an often painful condition characterized by exposed necrotic, or dying, bone. Dr. Eric Carlson, OMS, discusses treatments of MRONJ how it is important to know an OMS is experienced and knowledgeable in the prevention and treatment.
In this episode, we review the high-yield topic of Osteonecrosis of the Knee from the Knee & Sports section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message
In this episode, we review the high-yield topic of Avascular Necrosis of the Bone (Osteonecrosis) from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message
Enjoy another episode from our board review series featuring Dr. Cole and Dr. Woolwine. This episode is sponsored by the American Academy of Orthopaedic Surgeons: Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education. Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You'll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/.
In this episode, we review the high-yield topic of Spontaneous Osteonecrosis of the Knee (SONK) from the Knee & Sports section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message
In this episode, Daniel J. DeAngelo, MD, PhD; Kjeld Schmiegelow, MD, DMSci; and Emily Curran, MD, answer key questions asked by the audience during a live satellite symposium at the 2022 American Society of Hematology Annual Meeting on optimizing pediatric or pediatric-inspired regimens containing asparaginase for the treatment of young and older adults with acute lymphoblastic leukemia.Topics discussed include:Practical considerations for management of allergy-like reactions and hypersensitivity to asparaginaseIndirect methods for measuring asparaginase activityStrategies to mitigate adverse events with asparaginase treatment, including hepatotoxicity, pancreatitis, and thrombosisConsiderations for use of asparaginase in special populations (eg, high BMI, older age)Presenters:Program DirectorDaniel J. DeAngelo, MD, PhDProfessor of MedicineDepartment of MedicineHarvard Medical SchoolChief of the Division of LeukemiaDepartment of Medical OncologyDivision of Hematologic MalignanciesDana‐Farber Cancer InstituteBoston, MassachusettsEmily Curran, MDAssistant ProfessorDivision of Hematology/OncologyUniversity of Cincinnati Cancer InstituteCincinnati, OhioKjeld Schmiegelow, MD, DMSciProfessorDepartment of Pediatric OncologyRighospitalet University HospitalCopenhagen, DenmarkContent based on an online CME program supported by an independent educational grant from Jazz Pharmaceuticals.Link to full program:http://bit.ly/3YXkLyj
In this episode, we review the high-yield topic of Avascular Necrosis of the Bone (Osteonecrosis) from the Orthopedics section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Osteonecrosis of the Knee from the Knee & Sports section. This episode is sponsored by: Robin Healthcare Four out of five orthopedists say that note-taking interferes with patient care. Robin is here to change that. Robin provides ambient virtual scribing exclusively for orthopedics. The Robin Assistant device ambiently captures your visits and allows you to focus completely on patients. And its virtual scribes take care of your clinical notes and codes, so you also have more time to take care of patients. Visit robin.co/orthobullets to discover the difference ambient virtual scribing can have on your practice. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message
In this episode, Antonia and Andrew discuss a selection of articles from the June 15, 2022 issue of JBJS, along with an added dose of entertainment and pop culture. Listen at the gym, on your commute, or whenever your case is on hold! Articles Discussed: Modern External Ring Fixation Versus Internal Fixation for Treatment of Severe Open Tibial Fractures. A Randomized Clinical Trial (FIXIT Study), by O’Toole et al. Comparing the Risk of Osteonecrosis of the Femoral Head Following Intra-Articular Corticosteroid and Hyaluronic Acid Injections, by Varady et al. Creation of a Total Hip Arthroplasty Patient-Specific Dislocation Risk Calculator, by Wyles et al. Long-Term Results and Failure Analysis of the Open Latarjet Procedure and Arthroscopic Bankart Repair in Adolescents, by Waltenspül et al. Pre-Arthritic/Kinematic Alignment In Fixed-Bearing Medial Unicompartmental Knee Arthroplasty Results in Return to Activity at Mean 10-Year Follow-up, by Plancher et al. Risk of Revision After Hip Fracture Fixation Using DePuy Synthes Trochanteric Fixation Nail or Trochanteric Fixation Nail Advanced. A Cohort Study of 7,979 Patients, by Goodnough et al. Mesenchymal Stem Cell Exosomes Promote Growth Plate Repair and Reduce Limb-Length Discrepancy in Young Rats, by Wong et al. A Statistical Shape Model-Based Analysis of Periacetabular Osteotomies. Technical Considerations to Achieve the Targeted Correction, by Kriechling et al. Link: JBJS website: https://jbjs.org/issue.php Sponsor: This episode is brought to you by JBJS Clinical Classroom. Subspecialties: Basic Science Hip Knee Pediatrics Sho
In this episode, we review the high-yield topic of Spontaneous Osteonecrosis of the Knee (SONK) from the Knee & Sports section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message
In this episode, we review the high-yield topic of Hip Osteonecrosis from the Recon section. Follow Orthobullets on Social Media: Facebook: www.facebook.com/orthobullets Instagram: www.instagram.com/orthobulletsofficial Twitter: www.twitter.com/orthobullets LinkedIn: www.linkedin.com/company/27125689 YouTube: www.youtube.com/channel/UCMZSlD9OhkFG2t25oM14FvQ --- Send in a voice message: https://anchor.fm/orthobullets/message
This podcast highlights original research published in the November 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. The objective was to review long-term clinical and quality-of-life outcomes following free flap reconstruction for osteonecrosis. In conclusion, the majority of patients maintained or had advancement in diet following reconstruction, with low rates of osteonecrosis or cancer recurrence and above-average scores on UW-QOL survey suggesting good return of function and quality of life. Click here to read the full article.
Listen to this episode to know more about drug-induced osteonecrosis. Do you want to know more about oral diseases? Follow us on Instagram @doencasdeboca https://www.instagram.com/doencasdeboca/
AO Trauma North America Internet Live Series: Orthopaedic Trauma Journal Club
This Month's Selected Articles and Authors 1) Anna Miller....Helfet, Lorich. Quantitative Assessment of the vascularity of the talus with gadolinium-enhanced magnetic resonance imaging. 2)Eric Lindvall,... Roy Sanders. Open Reduction and Stable Fixation of Isolated, Displaced Talar Neck and Body Fractures 3) Heather Vallier et al. A New Look at the Hawkins Classification for Talar Neck Fractures: Which Features of Injury and Treatment Are Predictive of Osteonecrosis?
Welcome back to another episode. In this 30 minutes episode, we dive into all the medical adjunctive treatments for management of Medication induced osteonecrosis of the jaw. We will review clinically applicable modalities and what is on the horizon. Tune in and let us know what you like to listen to next. :) " Music from https://filmmusic.io: "Movement Proposition" by Kevin MacLeod (https://incompetech.com) Licence: CC BY (http://creativecommons.org/licenses/by/4.0/)" Music from https://filmmusic.io "Your Call" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
Welcome back to another episode of Oralmaxfax. in this episode we talk about ways to decrease the risk of developing osteonecrosis of the jaw on high risk patients after performing OMS procedure. And we shed light into the evidence behind each intervention. Tune in and let us know if you have any questions. " Music from https://filmmusic.io: "Movement Proposition" by Kevin MacLeod (https://incompetech.com) Licence: CC BY (http://creativecommons.org/licenses/by/4.0/)" Music from https://filmmusic.io "Your Call" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
This episode is an ACOMS CE credited episode. ADA CERP continuing dental education (CDE) credit is available for this activity. To claim your CDE credit please visit acoms.org/podcast and complete the post assessment and evaluation. CDE credit is free for ACOMS members and $25.00 dollars for non-members. Membership is free for residents and dental students. Welcome to another episode of Oralmaxfax. In this episode, we will start our two part conversations about medication induced osteonecrosis. In Part one, we dive into the medications that have been associated, pathophysiology of the disease and as well as breaking down the latest staging. Tune in here and check us on instagram at @oralmaxfax if you have any questions. " Music from https://filmmusic.io: "Movement Proposition" by Kevin MacLeod (https://incompetech.com) Licence: CC BY (http://creativecommons.org/licenses/by/4.0/)" Music from https://filmmusic.io "Your Call" by Kevin MacLeod (https://incompetech.com) License: CC BY (http://creativecommons.org/licenses/by/4.0/)
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Here I review the two common classifications for ON of the hip, Ficat and Steinberg.The modified Ficat, Idiopathic bone necrosis of the femoral head, was published in 1985 JBJS-Br0 - Preclinical and pre-radiographicI - Xray is normal but hip is symptomaticII - sclerosis and cysts on xrayIII - Crescent signIV - OA with a deformed headSteinberg, A quantitative system for staging avascular necrosis, JBJS-Br 19950 - Normal1 - Xray normal, BS +, MRI +2 - sclerosis and cysts on x-ray3 - crescent sign4 - flattening of the femoral head5 - joint space narrowed without acetabular involvement6 - advanced DJDfor stages 1 - 5 he further describes volume of involvementmild 30%Support the show (https://www.patreon/TotalKneeTips)
This week, we'll review a meta-analysis of several trials studying the efficacy of 3 vs 6 months of adjuvant chemotherapy for patients with advanced colon cancer. We'll also discuss a report on the frequency of osteonecrosis of the jaw among patients with metastatic bone disease treated with zoledronic acid, as well as several risk factors for the development of the condition.Coverage of stories discussed this week on ascopost.com:Final Overall Survival Results of the IDEA Collaboration: 3 vs 6 Months of Adjuvant Chemotherapy for Stage III Colon CancerRisk for Osteonecrosis of the Jaw After Treatment With Zoledronic Acid for Metastatic Bone DiseaseTo listen to more podcasts from ASCO, visit asco.org/podcasts.
Interview with Dr. Catherine Van Poznak, author of Association of Osteonecrosis of the Jaw With Zoledronic Acid Treatment for Bone Metastases in Patients With Cancer
Interview with Dr. Catherine Van Poznak, author of Association of Osteonecrosis of the Jaw With Zoledronic Acid Treatment for Bone Metastases in Patients With Cancer
Antonio Maltese, a senior studying political science in Virginia, is passionate about advocating for the rare disease community. He belongs to the community himself twice over, with a diagnosis of Huntington’s Disease and osteonecrosis. He speaks with Charles River scientists Lauren Black and David Fisher about his studies, their research, and how scientists and patients can help each other.
La invitada de hoy es la Dra Basov , Cirujano Maxilofacial, nos habla sobre este tema tan importante que conozcan los Odontólogos. Youtube: Dra Basov instagram: kseniabasov
An Author Interview with Dr. Brian DeFeo.
Our guest today is Sophia Anna, also known as "The Sick Sexy" and continues in our series on Sickle Cell. Born in 1993 and originally from England with a background of Greek and South American heritage, Sophia Anna is an online writer, content creator, model and works in healthcare. She is extremely passionate about invisible illness and launched her youtube channel: The Sick Sexy as an honest, raw platform about de-stigmatizing invisible illness and how to embrace it.
This lecture will cover the basic science and some pathologic processes leading to the the necessity of total joint reconstruction surgery.
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
Ibandronate is a bisphosphonate that can be used in the management of osteoporosis. Bisphosphonates like ibandronate require a full glass of water for oral administration. Patients should remain upright for at least 30-60 minutes following taking ibandronate to help reduce the risk of esophagitis. Osteonecrosis has rarely been associated with bisphosphonates like ibandronate - I've discussed a couple of risk factors that may place a patient at higher risk.
Word of Mouth: dentists discuss the oral-systemic connection
In season one, episode five of the integrative health podcast Word of Mouth, IAOMT member and past president, Stuart Nunnally, DDS, NMD, interviews Jerry Bouquot, DDS, MSD, about neuralgia-inducing cavitational osteonecrosis (NICO). Click below to learn more about cavitations from the IAOMT. https://iaomt.org/resources/articles/jawbone-osteonecrosis/
(Cápsula 032) Los huesos son elementos vivos que necesitan un adecuado suministro de oxígeno por medio de la sangre para permanecer vitales. Si el aporte de sangre disminuye, los componentes del hueso y la médula ósea pueden morir y provocar fallas con hundimientos en el hueso.Cuando esto sucede se conoce como un infarto óseo. Cuando un infarto óseo sucede en el extremo del hueso que hace parte de una articulación se llama osteonecrosis. ENLACE: https://www.reumatologia.online/blog/que-es-la-osteonecrosis
A 43 year old male presents to the emergency department with right wrist pain after falling on his outstretched right hand. You obtain an x-ray of the wrist, which demonstrates no acute fracture or dislocation. The patient is neurovascularly intact, you decided to discharge the patient home with instructions to treat with: ice, rest, and some naproxen. 14 months later, you're being sued by this very same patient, apparently, after you saw the patient their wrist pain never got better and in fact it persisted for over 8 months before they were finally seen again at another facility. They were then referred on to hand surgery where the diagnosis of a Scaphoid Fracture with Osteonecrosis due to non-union was made. The patient is suing you because they say you missed the fracture and now they have chronic wrist pain and limited functionality of the hand, so they're unable to make a living as a plumber, and their quality of life has dropped significantly. This is a fictional story, but very very common. Today we're going to talk about how to diagnose and how to not get burned by Scaphoid Fractures. - Do you a question you'd like for us to answer? Submit your question here (it's free) and we'll answer on our next podcast episode: https://www.askmedgeeks.com - Stay up to date with our monthly audio program In the Know. Get a free trial: https://www.medgeek.co/in-the-know-order-form-free - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our free resources here: https://medgeeks.co/start-here - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
Listen to Mr Andrew Duckworth interview Dr Matt Abdel about his paper "Reliable outcomes and survivorship of primary total knee arthroplasty for osteonecrosis of the knee", published in the November 2019 issue of The Bone and Joint Journal.Click here to read the article
An interview with Dr. Noam Yarom, Dr. Charles Shapiro, Dr. Deborah Saunders and Dr. Doug Peterson on "Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline." This guideline addresses the prevention and management of MRONJ in patients with cancer. This guideline is intended for oncologists and other physicians, dentists, dental specialists, oncology nurses, clinical researchers, oncology pharmacists, advanced practitioners, and patients with cancer. Read the full guideline at www.asco.org/supportive-care-guidelines Find all of the ASCO podcasts at podcast.asco.org TRANSCRIPT Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Hello, and welcome to the ASCO Guidelines podcast series. My name is Shannon McKernin. And today, I'm interviewing a panel of authors from "Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline." So could I have you each introduce yourselves for the listeners today? Thank you, Shannon. I'm Dr. Deborah Saunders. I'm the president of the International Society of Oral Oncology and was the section head for the Systematic Review on "Medication-Related Osteonecrosis of the Jaw," with MASCC and ISOO. I was a proud part of the steering committee and one of the authors. Thank you, Debbie. My name is Dr. Douglas Peterson. I am professor of oral medicine in the School of Dental Medicine at the University of Connecticut Health Center in Farmington, Connecticut. I am also a faculty member in the Head and Neck Cancer Oral Oncology Program at the university's Neag Comprehensive Cancer Center. I'm a member of the steering committee for this clinical practice guideline and one of the co-authors as well. In addition, and as of June 2019, I have been serving as chair elect during this next year for ASCO's Clinical Practice Guidelines committee. Thank you, Doug. My name is Noam Yarom. I'm an all medicine specialist from the Sheba Medical Center in Tel Aviv University in Israel. I'm serving as a culture of this guideline, and it is a pleasure to be with you today. Thanks, Noam. I am Dr. Charles Shapiro, professor of medicine at the Mt. Sinai Hospital in New York. And I'm co-chair of the guideline "Medical-Related Osteonecrosis of the Jaw." And I'm happy to be here. Thank you all for being here today to discuss this guideline on the podcast. So first, can you give us a general overview of what this guideline covers. Sure. So you know, ASCO and MASCC, as well as ISOO decided that it would be great to provide a practical evidence-based approach in a multidisciplinary type setting to address this important topic that impacts all of our professions, that being medication-related osteonecrosis of the jaw. It's terminology and its definition and the path that's varied and even part of this publication identifies the need for us to move forward with a concise definition and similar terminology, that being medication-related osteonecrosis of the jaw. Medication-related osteonecrosis of the jaw is defined as the presence of an exposed or bone that is probable by a probe in a patient that has a history or is undergoing present use of a bone-modifying agent. This being in the absence of any patients having received any radiation to the head and neck and the absence of metastatic lesions to the jaw. The importance of us identifying this definition and agreeing on the terminology allows us to move forward in future publication to better compare outcome and provide better prevention and treatment for our patients moving forward. And what are the key recommendations of this guideline? There are six clinical questions associated with this clinical practice guideline as well as a series of recommendations built within each of the clinical questions. Clinical question one is directed to the preferred terminology and definition for osteonecrosis of the jaw, both of the maxilla and the mandible, as associated with pharmacologic therapies in oncology patients. The panel recommends that the term medication-related osteonecrosis of the jaw, MROJ, be used when referring to bone necrosis associated with pharmacologic therapies. As Dr. Saunders has described, the definition contains three key elements-- current or previous treatment with a bone-modifying agent or angiogenic inhibitor, exposed bone, or bone that can be probed through an intra or extra-oral fistula in the maxillofacial region and that has persisted for longer than eight weeks. And third, no history of radiation therapy to the jaws and no history of metastatic disease to the jaws. Clinical question two is directed to specific steps that should be taken to reduce the risk of MRONJ. The recommendation begins with emphasizing the absolute importance of interprofessional communication of the oncology team with the dental team in advance of initiating the bone-modifying agent. For patients with cancer who are scheduled to receive a bone-modifying agent in a non-urgent setting, a comprehensive oral care assessment, including dental examination and periodontal examination and an oral radiographic exam when feasible to do so should be undertaken prior to initiating the BMA therapy. Once the dental care plan has been developed, it should be discussed with the dental team, the patient, and the rest of the oncology team and then implemented based on medically necessary dental procedures. These procedures should be performed prior to the initiation of the bone-modifying agent. Once the bone-modifying agent is implemented, there should be ongoing followup by the dentist on a routine schedule, for example, every six months following initiation of the BMA therapy. It's also important to realize that there are a series of modifiable risk factors which should be emphasized with the patient. For example, poor oral health, invasive dental procedures, ill-fitting dentures, uncontrolled diabetes mellitus, and tobacco use are all factors that have been associated with development of a MRONJ. All of these modifiable risk factors should be addressed, where appropriate, with the patient in advance of the bone-modifying agent. As far as elective dental alveolar surgery, these procedures, if they are not medically necessary, for example, extractions or alveoloplasties or implants, they should not be performed during active therapy with a bone-modifying agent being given at an oncologic dose. Now, exceptions to this may be considered when a dental specialist with expertise in prevention and treatment of MROJ has reviewed the benefits and risks of the proposed invasive procedures with the patient and the oncology team. In general, however, elective dental alveolar surgical procedures should be deferred while the patient is undergoing active therapy with a bone-modifying agent. If the dental alveolar surgery is performed, the patient should be evaluated by a dental specialist on a systematic and frequently scheduled basis, for example, every six to eight weeks until there is full mucosal coverage of the surgical site. And once again, communication between the dental team and the rest of the oncology team is absolutely paramount in assuring ongoing comprehensive care of the patient. Interestingly, there are still questions in the literature relative to whether or not there should be temporary discontinuation of bone-modifying agents prior to dental alveolar surgery. Unfortunately, there remains insufficient evidence to support or refute the need for discontinuation of the bone-modifying agent prior to dental alveolar surgery. And so the administration of the bone-modifying agent may be deferred at the discretion of the treating physician, in conjunction with discussion with the patient and the oral health provider. So it really becomes an individual judgment call by the treating physician relative to whether or not to temporarily discontinue the bone-modifying agent prior to dental alveolar surgery. Clinical question three involves the staging of MROJ. There are a number of well-established staging systems in the literature addressing severity and extent of MROJ. For example, the 2014 American Academy of Oral and Maxillofacial Surgeons Staging System is one example. Another example is the National Cancer Institute's Common Terminology Criteria For Adverse Events. And there is a 2017 International Task Force on O and J Staging System for MROJ that is available as well. So there are at least three well-established, widely utilized staging systems for MROJ. Having said this, it's important in the view of the panel that the same staging system should be used throughout an individual patient's MROJ course of care. And optimally, the staging should be performed by a clinician experienced with the management of MROJ. Clinical question four involves management of MROJ directly. Here, the recommendations talk in terms of initial treatment of MROJ, which is centered in conservative measures. Now, these conservative measures may include antimicrobial mouth rinses, antibiotics if clinically indicated, effective oral hygiene, and conservative surgical intervention such as a removal of a superficial bone spicule. In cases, however, of refractory MROJ, more advanced MROJ, aggressive surgical interventions, for example, mucosal flap elevations, bloc resections of necrotic bone may be used if MROJ is persisting and severely affects function despite conservative initial treatment. Clinical question five involves bone-modifying agents and whether they should be temporarily discontinued after a diagnosis of MROJ has been established. And once again, there is insufficient evidence to support or refute the discontinuation of the bone-modifying agents after a diagnosis of MROJ has been established. The bone-modifying agent may be deferred at the discretion of the treating physician, again in discussion with the patient and the oral health care provider. And finally, clinical question six involves what outcome measures that should be utilized in clinical practice to describe the response of MROJ lesion to treatment. During the course of MROJ treatment, the dentist, dental specialist, should communicate with a medical oncologist in an ongoing way, both the objective and subjective status of the lesion. The guideline presents a scale that can be utilized to describe the trajectory of the MROJ-- resolved, improving, stable, or progressive. The clinical course of MROJ may impact both local and systemic treatment decisions relative to the cessation or the recommencement of bone-modifying agents. So once again, it becomes very, very important that the ongoing interprofessional communication relative to the clinical course of MROJ-- resolved, improving, stable, or progressive-- be discussed with the oncology team. Great. Thank you, Dr. Peterson. So on that last note, how can oncologists, dental specialists, and dentists all work together to manage medication-related osteonecrosis of the jaw? Throughout these guidelines, we do emphasize the importance of collaboration among the cancer care team, dentist, and dental specialists in order to coordinate care and modify risk factors. It is very important that cancer care team and the dental care team speak the same language. Therefore, we spend time on clarifying the definitions, the diagnostic criteria, and staging of MROJ. As been said earlier, we have developed a new system to evaluate the response to treatment, which is based both on objective findings and symptoms. By using this scale, oncologists and dentists would be able to communicate more easily for the benefit of the patients. We emphasized the need for multidisciplinary discussion in a few critical points throughout the course of bone-modifying agent therapy. And it is most important in case of a planned oral surgery in a patient without MROJ or before aggressive surgical treatment of refractory MROJ. And how will these guideline recommendations affect patients, and what should they talk to their doctors about? There are a number of things that patients, providers, dental specialists, and medical oncologists can do to lessen the risk and prevent MROJ. Because the key to MROJ is prevention. Once MROJ is established, it's difficult to treat, impacting a patient's quality of life. So we want to prevent, reduce the risk of developing MROJ. Patients can do a number of things-- pursue good oral hygiene, stop smoking, or reduce smoking, and control their diabetes, for example. Those things lessen the risk of MROJ. Providers, dental providers, dental specialists, who are specialized in the area or providers, dentists otherwise in the community, when they encounter a patient that's contemplating bone-modifying agents, they can do what's called a complete dental screening exam, which involves a complete examination of the mouth, Panorex X-rays and X-rays as clinically indicated. We want to identify work in the mouth that needs to be repaired before initiating bone-modifying agents. That way, we don't have to deal with an emergent situation when it could be preventable prior to bone-modifying agents, because one of the single highest risk factors for MROJ is emergent dental work while you're on bisphosphonate or another anti-resorptive agent-- bone-modifying agents. So a dental screening exam is critical to prevent or reduce the risk of MROJ. And medical oncologists have a role too in communication with the dental specialists and really think hard about the indications for bone-modifying agents, whether it be for osteoporosis, whether it be for metastatic disease, and whether it be for anti-cancer effects. And finally, where can both patients and clinicians go to get more information on this topic or to find a dentist or a dental specialist? Now, as far as websites, ASCO, MASCC, and ISSO all have websites you can go to to find out more information about MROJ. Yeah, I think that's great advice. Our links for additional information are listed in the Clinical Practice Guideline as well. This is a really first step at a framework in trying to manage a side effect that affects our patients but is very multidisciplinary. And like Dr. Shapiro was saying, really the best way to prevent this is with proper communication between the dentist and the oncologist and making the patient aware of what is needed prior to commencement of these treatments. Well, it certainly sounds as though there are some important considerations for clinicians and patients. And I really hope that this guideline is widely read and makes a real impact on the management of osteonecrosis and the communication between oncologists, dental specialists, and dentists. So from me and all of our listeners, thank you all for coming on the podcast today to discuss "Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline." Thank you. Thank you for having us. Thank you very much for this opportunity to contribute to this important discussion. Thank you for allowing me to participate in this important podcast. And thank you to all of our listeners for tuning into the ASCO Guidelines Podcast series. To read the full guideline, go www.asco.org/supportive-care-guidelines. And if you've enjoyed what you've heard today, please rate and review the podcast and refer the show to a colleague.
An interview with Dr. Noam Yarom, Dr. Charles Shapiro, Dr. Deborah Saunders and Dr. Doug Peterson on "Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline." This guideline addresses the prevention and management of MRONJ in patients with cancer. This guideline is intended for oncologists and other physicians, dentists, dental specialists, oncology nurses, clinical researchers, oncology pharmacists, advanced practitioners, and patients with cancer. Read the full guideline at www.asco.org/supportive-care-guidelines Find all of the ASCO podcasts at podcast.asco.org TRANSCRIPT Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Hello, and welcome to the ASCO Guidelines podcast series. My name is Shannon McKernin. And today, I'm interviewing a panel of authors from "Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline." So could I have you each introduce yourselves for the listeners today? Thank you, Shannon. I'm Dr. Deborah Saunders. I'm the president of the International Society of Oral Oncology and was the section head for the Systematic Review on "Medication-Related Osteonecrosis of the Jaw," with MASCC and ISOO. I was a proud part of the steering committee and one of the authors. Thank you, Debbie. My name is Dr. Douglas Peterson. I am professor of oral medicine in the School of Dental Medicine at the University of Connecticut Health Center in Farmington, Connecticut. I am also a faculty member in the Head and Neck Cancer Oral Oncology Program at the university's Neag Comprehensive Cancer Center. I'm a member of the steering committee for this clinical practice guideline and one of the co-authors as well. In addition, and as of June 2019, I have been serving as chair elect during this next year for ASCO's Clinical Practice Guidelines committee. Thank you, Doug. My name is Noam Yarom. I'm an all medicine specialist from the Sheba Medical Center in Tel Aviv University in Israel. I'm serving as a culture of this guideline, and it is a pleasure to be with you today. Thanks, Noam. I am Dr. Charles Shapiro, professor of medicine at the Mt. Sinai Hospital in New York. And I'm co-chair of the guideline "Medical-Related Osteonecrosis of the Jaw." And I'm happy to be here. Thank you all for being here today to discuss this guideline on the podcast. So first, can you give us a general overview of what this guideline covers. Sure. So you know, ASCO and MASCC, as well as ISOO decided that it would be great to provide a practical evidence-based approach in a multidisciplinary type setting to address this important topic that impacts all of our professions, that being medication-related osteonecrosis of the jaw. It's terminology and its definition and the path that's varied and even part of this publication identifies the need for us to move forward with a concise definition and similar terminology, that being medication-related osteonecrosis of the jaw. Medication-related osteonecrosis of the jaw is defined as the presence of an exposed or bone that is probable by a probe in a patient that has a history or is undergoing present use of a bone-modifying agent. This being in the absence of any patients having received any radiation to the head and neck and the absence of metastatic lesions to the jaw. The importance of us identifying this definition and agreeing on the terminology allows us to move forward in future publication to better compare outcome and provide better prevention and treatment for our patients moving forward. And what are the key recommendations of this guideline? There are six clinical questions associated with this clinical practice guideline as well as a series of recommendations built within each of the clinical questions. Clinical question one is directed to the preferred terminology and definition for osteonecrosis of the jaw, both of the maxilla and the mandible, as associated with pharmacologic therapies in oncology patients. The panel recommends that the term medication-related osteonecrosis of the jaw, MROJ, be used when referring to bone necrosis associated with pharmacologic therapies. As Dr. Saunders has described, the definition contains three key elements-- current or previous treatment with a bone-modifying agent or angiogenic inhibitor, exposed bone, or bone that can be probed through an intra or extra-oral fistula in the maxillofacial region and that has persisted for longer than eight weeks. And third, no history of radiation therapy to the jaws and no history of metastatic disease to the jaws. Clinical question two is directed to specific steps that should be taken to reduce the risk of MRONJ. The recommendation begins with emphasizing the absolute importance of interprofessional communication of the oncology team with the dental team in advance of initiating the bone-modifying agent. For patients with cancer who are scheduled to receive a bone-modifying agent in a non-urgent setting, a comprehensive oral care assessment, including dental examination and periodontal examination and an oral radiographic exam when feasible to do so should be undertaken prior to initiating the BMA therapy. Once the dental care plan has been developed, it should be discussed with the dental team, the patient, and the rest of the oncology team and then implemented based on medically necessary dental procedures. These procedures should be performed prior to the initiation of the bone-modifying agent. Once the bone-modifying agent is implemented, there should be ongoing followup by the dentist on a routine schedule, for example, every six months following initiation of the BMA therapy. It's also important to realize that there are a series of modifiable risk factors which should be emphasized with the patient. For example, poor oral health, invasive dental procedures, ill-fitting dentures, uncontrolled diabetes mellitus, and tobacco use are all factors that have been associated with development of a MRONJ. All of these modifiable risk factors should be addressed, where appropriate, with the patient in advance of the bone-modifying agent. As far as elective dental alveolar surgery, these procedures, if they are not medically necessary, for example, extractions or alveoloplasties or implants, they should not be performed during active therapy with a bone-modifying agent being given at an oncologic dose. Now, exceptions to this may be considered when a dental specialist with expertise in prevention and treatment of MROJ has reviewed the benefits and risks of the proposed invasive procedures with the patient and the oncology team. In general, however, elective dental alveolar surgical procedures should be deferred while the patient is undergoing active therapy with a bone-modifying agent. If the dental alveolar surgery is performed, the patient should be evaluated by a dental specialist on a systematic and frequently scheduled basis, for example, every six to eight weeks until there is full mucosal coverage of the surgical site. And once again, communication between the dental team and the rest of the oncology team is absolutely paramount in assuring ongoing comprehensive care of the patient. Interestingly, there are still questions in the literature relative to whether or not there should be temporary discontinuation of bone-modifying agents prior to dental alveolar surgery. Unfortunately, there remains insufficient evidence to support or refute the need for discontinuation of the bone-modifying agent prior to dental alveolar surgery. And so the administration of the bone-modifying agent may be deferred at the discretion of the treating physician, in conjunction with discussion with the patient and the oral health provider. So it really becomes an individual judgment call by the treating physician relative to whether or not to temporarily discontinue the bone-modifying agent prior to dental alveolar surgery. Clinical question three involves the staging of MROJ. There are a number of well-established staging systems in the literature addressing severity and extent of MROJ. For example, the 2014 American Academy of Oral and Maxillofacial Surgeons Staging System is one example. Another example is the National Cancer Institute's Common Terminology Criteria For Adverse Events. And there is a 2017 International Task Force on O and J Staging System for MROJ that is available as well. So there are at least three well-established, widely utilized staging systems for MROJ. Having said this, it's important in the view of the panel that the same staging system should be used throughout an individual patient's MROJ course of care. And optimally, the staging should be performed by a clinician experienced with the management of MROJ. Clinical question four involves management of MROJ directly. Here, the recommendations talk in terms of initial treatment of MROJ, which is centered in conservative measures. Now, these conservative measures may include antimicrobial mouth rinses, antibiotics if clinically indicated, effective oral hygiene, and conservative surgical intervention such as a removal of a superficial bone spicule. In cases, however, of refractory MROJ, more advanced MROJ, aggressive surgical interventions, for example, mucosal flap elevations, bloc resections of necrotic bone may be used if MROJ is persisting and severely affects function despite conservative initial treatment. Clinical question five involves bone-modifying agents and whether they should be temporarily discontinued after a diagnosis of MROJ has been established. And once again, there is insufficient evidence to support or refute the discontinuation of the bone-modifying agents after a diagnosis of MROJ has been established. The bone-modifying agent may be deferred at the discretion of the treating physician, again in discussion with the patient and the oral health care provider. And finally, clinical question six involves what outcome measures that should be utilized in clinical practice to describe the response of MROJ lesion to treatment. During the course of MROJ treatment, the dentist, dental specialist, should communicate with a medical oncologist in an ongoing way, both the objective and subjective status of the lesion. The guideline presents a scale that can be utilized to describe the trajectory of the MROJ-- resolved, improving, stable, or progressive. The clinical course of MROJ may impact both local and systemic treatment decisions relative to the cessation or the recommencement of bone-modifying agents. So once again, it becomes very, very important that the ongoing interprofessional communication relative to the clinical course of MROJ-- resolved, improving, stable, or progressive-- be discussed with the oncology team. Great. Thank you, Dr. Peterson. So on that last note, how can oncologists, dental specialists, and dentists all work together to manage medication-related osteonecrosis of the jaw? Throughout these guidelines, we do emphasize the importance of collaboration among the cancer care team, dentist, and dental specialists in order to coordinate care and modify risk factors. It is very important that cancer care team and the dental care team speak the same language. Therefore, we spend time on clarifying the definitions, the diagnostic criteria, and staging of MROJ. As been said earlier, we have developed a new system to evaluate the response to treatment, which is based both on objective findings and symptoms. By using this scale, oncologists and dentists would be able to communicate more easily for the benefit of the patients. We emphasized the need for multidisciplinary discussion in a few critical points throughout the course of bone-modifying agent therapy. And it is most important in case of a planned oral surgery in a patient without MROJ or before aggressive surgical treatment of refractory MROJ. And how will these guideline recommendations affect patients, and what should they talk to their doctors about? There are a number of things that patients, providers, dental specialists, and medical oncologists can do to lessen the risk and prevent MROJ. Because the key to MROJ is prevention. Once MROJ is established, it's difficult to treat, impacting a patient's quality of life. So we want to prevent, reduce the risk of developing MROJ. Patients can do a number of things-- pursue good oral hygiene, stop smoking, or reduce smoking, and control their diabetes, for example. Those things lessen the risk of MROJ. Providers, dental providers, dental specialists, who are specialized in the area or providers, dentists otherwise in the community, when they encounter a patient that's contemplating bone-modifying agents, they can do what's called a complete dental screening exam, which involves a complete examination of the mouth, Panorex X-rays and X-rays as clinically indicated. We want to identify work in the mouth that needs to be repaired before initiating bone-modifying agents. That way, we don't have to deal with an emergent situation when it could be preventable prior to bone-modifying agents, because one of the single highest risk factors for MROJ is emergent dental work while you're on bisphosphonate or another anti-resorptive agent-- bone-modifying agents. So a dental screening exam is critical to prevent or reduce the risk of MROJ. And medical oncologists have a role too in communication with the dental specialists and really think hard about the indications for bone-modifying agents, whether it be for osteoporosis, whether it be for metastatic disease, and whether it be for anti-cancer effects. And finally, where can both patients and clinicians go to get more information on this topic or to find a dentist or a dental specialist? Now, as far as websites, ASCO, MASCC, and ISSO all have websites you can go to to find out more information about MROJ. Yeah, I think that's great advice. Our links for additional information are listed in the Clinical Practice Guideline as well. This is a really first step at a framework in trying to manage a side effect that affects our patients but is very multidisciplinary. And like Dr. Shapiro was saying, really the best way to prevent this is with proper communication between the dentist and the oncologist and making the patient aware of what is needed prior to commencement of these treatments. Well, it certainly sounds as though there are some important considerations for clinicians and patients. And I really hope that this guideline is widely read and makes a real impact on the management of osteonecrosis and the communication between oncologists, dental specialists, and dentists. So from me and all of our listeners, thank you all for coming on the podcast today to discuss "Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline." Thank you. Thank you for having us. Thank you very much for this opportunity to contribute to this important discussion. Thank you for allowing me to participate in this important podcast. And thank you to all of our listeners for tuning into the ASCO Guidelines Podcast series. To read the full guideline, go www.asco.org/supportive-care-guidelines. And if you've enjoyed what you've heard today, please rate and review the podcast and refer the show to a colleague.
In this episode, we review multiple choice questions related to the high-yield topics of Ankylosing Spondylitis, Hip Osteonecrosis & Osteogenesis Imperfecta. --- Send in a voice message: https://anchor.fm/orthobullets/message
In this episode, we review the high-yield topic of Hip Osteonecrosis from the Recon section. --- Send in a voice message: https://anchor.fm/orthobullets/message
In this episode, I discuss the increasing use of the Intensive Care Unit for a. Digenic infections over the last decade in Australia. I also discuss the conservative treatment of medication-related osteonecrosis of the Jaws and the success rates and spontaneous resolution of this process that you can expect from this modality and this treatment course. I also discussed the use of a C-Arm intraoperatively vs CT scans for complex facial fractures.
In this episode, we review the high-yield topic of Spontaneous Osteonecrosis of the Knee (SONK) from the Sports section. Topic: https://www.orthobullets.com/knee-and-sports/3026/spontaneous-osteonecrosis-of-the-knee-sonk?expandLeftMenu=true --- Send in a voice message: https://anchor.fm/orthobullets/message
In this episode of PodMD, orthopaedic surgeon, Mr Raghavan Unni discusses Spontaneous osteonecrosis of the knee (SONK).
Dr Karol presents, at a press conference at ASH 2015, results from a study looking at genetic risk factors for the development of osteonecrosis in children under age 10 treated for acute lymphoblastic leukaemia.
Dr Stock talks to ecancertv at ASH 2015 on a study that looked at genetic risk factors for the development of osteonecrosis in children aged 10 years or younger who were being treated for acute lymphoblastic leukaemia. The study, presented by Dr Seth Karol of St Jude Children's Research Hospital in Tampa, USA, showed that children who developed osteonecrosis were more likely to have genetic variants near a gene important to bone development (BMP7) and a gene important to fat levels in the blood (PROX1) than those who did not develop the bone disease.
Dr Karol talks to ecancertv at ASH 2015 about genetic risk factors for the development of osteonecrosis in children under age 10 treated for acute lymphoblastic leukaemia. Osteonecrosis or avascular necrosis is a treatment-limiting toxicity associated with chemotherapy, Dr Karol explains. So identifying who may be most at risk of experiencing this side effect would be very useful. Dr Karol discusses preliminary results of a genome-wide association study involving 1,186 children, with an initial discovery group of 82 children with and 287 without osteonecrosis. It was found that children who developed osteonecrosis were more likely to have genetic variants near a gene important to bone development (BMP7) and a gene important to fat levels in the blood (PROX1) than those who did not develop the bone disease.
Dr Marx speaks with ecancer at NOSCM 2017 to discuss osteonecrosis of the jaw. He outlines the cancer drugs linked to disease onset, and gives the perspective of facial/dental surgeons in minimising adverse events and promoting therapy adherence. In terms of managing infection, Dr Marx recommends penicillin-based antibiotics or anthracyclines, and in the case of advanced disease he describes how surgical interventions can preserve appearance and quality of life.
Dr. Benjamin Levy, Mount Sinai Health Systems, compares zoledronic acid and denosumab, two agents used for treatment of bone metastases in lung cancer.
Dr. Benjamin Levy, Mount Sinai Health Systems, compares zoledronic acid and denosumab, two agents used for treatment of bone metastases in lung cancer.
Dr. Benjamin Levy, Mount Sinai Health Systems, compares zoledronic acid and denosumab, two agents used for treatment of bone metastases in lung cancer.
This JCO Podcast provides observations and commentary on the JCO article “Osteonecrosis of the Jaw and Oral Health-Related Quality of Life After Adjuvant Zoledronic Acid: An Adjuvant Zoledronic Acid to Reduce Recurrence Trial Subprotocol (BIG01/04)" by Emma Rathbone et al.
Bisphosphonate associated osteonecrosis of the jaw, prevention, management and the dental hygienist's role Claire Berrisford
Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe complication of bisphosphonate therapy. Due to their long survival and subsequently high cumulative doses of bisphosphonates, multiple myeloma patients have the highest risk of developing BRONJ of all patients treated with bisphosphonates. The purpose of the present study was to evaluate the incidence and risk factors for BRONJ in multiple myeloma patients after high-dose chemotherapy and autologous stem cell transplantation (ASCT). Patients and Methods: We retrospectively analyzed the data of 120 multiple myeloma patients after high-dose chemotherapy and ASCT treated with bisphosphonates and assessed the incidence and risk factors of BRONJ. Results: Of the 120 patients, 23 (19%) developed BRONJ. 6 patients suffered several BRONJ events, resulting in a total incidence of 23%. The risk for BRONJ was significantly higher for patients with rheumatism and recent dental manipulations. Furthermore, the number of previous bisphosphonate rotations, the duration of bisphosphonate therapy, and the type and cumulative dose of bisphosphonate used were associated with the incidence of BRONJ. Conclusion: Our study is the first to determine the risk of BRONJ in a homogeneous group of multiple myeloma patients treated with high-dose chemotherapy and ASCT.
This podcast summarizes the incidence and long-term outcome of osteonecrosis in a large prospective study of children treated for acute lymphhoblastic leukemia with the dexamethasone-based Dutch Childhood Oncology Group-ALL 9 Protocol.
Host: Lee Freedman, MD Guest: John Carey, MB, BCh, BAO What are the mechanisms that are suspect for increasing incidence of osteonecrosis of the jaw in those taking bisphosphonates? Is this a significant risk? Dr. John Carey, consultant physician in internal medicine and rheumatology at Galway University Hospitals, reviews the evidence potentially modifying or increasing the risk of patients developing osteonecrosis of the jaw if they take bisphosphonates. Do patients need an oral exam before they begin taking bisphosphonates? Dr. Lee Freedman hosts.
Fosamax has been linked with Osteonecrosis of the Jawbone. Osteonecrosis refers to death of a bone; the bone tissue rots and dies due to lack of blood supply. In Osteonecrosis of the Jawbone, parts of the jaw bone rot and may fail to heal following oral surgery or dental work. Patients taking Fosamax are at a higher risk for developing Osteonecrosis of the Jawbone. Did you or a loved one suffer side effects while taking Fosamax? If so, you have legal rights. Women taking Fosamax or who took it in the past are urged to contact Mark & Associates P.C. today for a FREE legal consultation. In many cases, our defective drug lawyers are able to win compensation for patients who suffered complications such as Osteonecrosis of the Jaw as a result of taking the osteoporosis drug. Mark & Associates P.C. takes NO legal fees whatsoever unless we win or settle your Fosamax case. Call 1-866-50-RIGHTS (1-866-507-4448) to speak with a lawyer today, or fill out our case review form on youhaverights.com and someone will contact you.
Fosamax has been linked with Osteonecrosis of the Jawbone. Osteonecrosis refers to death of a bone; the bone tissue rots and dies due to lack of blood supply. In Osteonecrosis of the Jawbone, parts of the jaw bone rot and may fail to heal following oral surgery or dental work. Patients taking Fosamax are at a higher risk for developing Osteonecrosis of the Jawbone. Did you or a loved one suffer side effects while taking Fosamax? If so, you have legal rights. Women taking Fosamax or who took it in the past are urged to contact Mark & Associates P.C. today for a FREE legal consultation. In many cases, our defective drug lawyers are able to win compensation for patients who suffered complications such as Osteonecrosis of the Jaw as a result of taking the osteoporosis drug. Mark & Associates P.C. takes NO legal fees whatsoever unless we win or settle your Fosamax case. Call 1-866-50-RIGHTS (1-866-507-4448) to speak with a lawyer today, or fill out our case review form on youhaverights.com and someone will contact you.
A PTJ podcast titled 'Relationships Among Severity of Osteonecrosis, Pain, Range of Motion, and Functional Mobility in Children, Adolescents, and Young Adults With Acute Lymphoblastic Leukemia '
© 2020-2025 Ivy Podcast Discovery LLC
