Denosumab‐related osteonecrosis of the jaw following non‐surgical periodontal therapy: A case report
Introduction Osteonecrosis of the jaw associated with bisphosphonates is currently called medication‐related osteonecrosis of the jaw (MRONJ), given that in addition to bisphosphonates, jaw osteonecrosis has been related to the administration of other antiresorptive and antiangiogenic drugs, such as...
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| Veröffentlicht in: | Journal of clinical periodontology 2018-05, Vol.45 (5), p.570-577 |
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| creator | Diniz‐Freitas, Márcio Fernández‐Feijoo, Javier Diz Dios, Pedro Pousa, Xiana Limeres, Jacobo |
| description | Introduction
Osteonecrosis of the jaw associated with bisphosphonates is currently called medication‐related osteonecrosis of the jaw (MRONJ), given that in addition to bisphosphonates, jaw osteonecrosis has been related to the administration of other antiresorptive and antiangiogenic drugs, such as denosumab, sunitinib, bevacizumab and ipilimumab.
Case Presentation
A 77‐year‐old patient with osteoporosis treated with subcutaneous injections of denosumab at an interval of 6 months is presented. The patient developed MRONJ after receiving a non‐surgical periodontal therapy. Although the MRONJ was initially classified as a stage I lesion in this patient, cone beam computed tomography images confirmed the presence of a significant osteolytic lesion. Treatment consisted of the administration of chlorhexidine mouthwash and systemic doxycycline, exodontia of the involved teeth, sequestrectomy and complete surgical debridement of the necrotic bone.
Conclusion
To our knowledge, this is the first case reported in the literature of MRONJ following non‐surgical periodontal therapy in a patient with osteoporosis treated with denosumab. The risk of MRONJ development after a periodontal procedure and how to prevent this complication are still unknown. |
| doi_str_mv | 10.1111/jcpe.12882 |
| format | Article |
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Osteonecrosis of the jaw associated with bisphosphonates is currently called medication‐related osteonecrosis of the jaw (MRONJ), given that in addition to bisphosphonates, jaw osteonecrosis has been related to the administration of other antiresorptive and antiangiogenic drugs, such as denosumab, sunitinib, bevacizumab and ipilimumab.
Case Presentation
A 77‐year‐old patient with osteoporosis treated with subcutaneous injections of denosumab at an interval of 6 months is presented. The patient developed MRONJ after receiving a non‐surgical periodontal therapy. Although the MRONJ was initially classified as a stage I lesion in this patient, cone beam computed tomography images confirmed the presence of a significant osteolytic lesion. Treatment consisted of the administration of chlorhexidine mouthwash and systemic doxycycline, exodontia of the involved teeth, sequestrectomy and complete surgical debridement of the necrotic bone.
Conclusion
To our knowledge, this is the first case reported in the literature of MRONJ following non‐surgical periodontal therapy in a patient with osteoporosis treated with denosumab. The risk of MRONJ development after a periodontal procedure and how to prevent this complication are still unknown.</description><identifier>ISSN: 0303-6979</identifier><identifier>EISSN: 1600-051X</identifier><identifier>DOI: 10.1111/jcpe.12882</identifier><identifier>PMID: 29479739</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Bevacizumab ; Bisphosphonates ; Case reports ; Chlorhexidine ; Computed tomography ; denosumab ; Doxycycline ; Immunotherapy ; Jaw ; medication‐related osteonecrosis of the jaw ; Monoclonal antibodies ; Mouthwashes ; Osteolysis ; Osteonecrosis ; Osteoporosis ; Patients ; Periodontics ; Teeth</subject><ispartof>Journal of clinical periodontology, 2018-05, Vol.45 (5), p.570-577</ispartof><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3242-ed758d0327eb7ae8611e85e0435e7eff8e8e337f8d63e1a2214ab8d951593d523</citedby><cites>FETCH-LOGICAL-c3242-ed758d0327eb7ae8611e85e0435e7eff8e8e337f8d63e1a2214ab8d951593d523</cites><orcidid>0000-0001-5349-1091</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpe.12882$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpe.12882$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29479739$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diniz‐Freitas, Márcio</creatorcontrib><creatorcontrib>Fernández‐Feijoo, Javier</creatorcontrib><creatorcontrib>Diz Dios, Pedro</creatorcontrib><creatorcontrib>Pousa, Xiana</creatorcontrib><creatorcontrib>Limeres, Jacobo</creatorcontrib><title>Denosumab‐related osteonecrosis of the jaw following non‐surgical periodontal therapy: A case report</title><title>Journal of clinical periodontology</title><addtitle>J Clin Periodontol</addtitle><description>Introduction
Osteonecrosis of the jaw associated with bisphosphonates is currently called medication‐related osteonecrosis of the jaw (MRONJ), given that in addition to bisphosphonates, jaw osteonecrosis has been related to the administration of other antiresorptive and antiangiogenic drugs, such as denosumab, sunitinib, bevacizumab and ipilimumab.
Case Presentation
A 77‐year‐old patient with osteoporosis treated with subcutaneous injections of denosumab at an interval of 6 months is presented. The patient developed MRONJ after receiving a non‐surgical periodontal therapy. Although the MRONJ was initially classified as a stage I lesion in this patient, cone beam computed tomography images confirmed the presence of a significant osteolytic lesion. Treatment consisted of the administration of chlorhexidine mouthwash and systemic doxycycline, exodontia of the involved teeth, sequestrectomy and complete surgical debridement of the necrotic bone.
Conclusion
To our knowledge, this is the first case reported in the literature of MRONJ following non‐surgical periodontal therapy in a patient with osteoporosis treated with denosumab. The risk of MRONJ development after a periodontal procedure and how to prevent this complication are still unknown.</description><subject>Bevacizumab</subject><subject>Bisphosphonates</subject><subject>Case reports</subject><subject>Chlorhexidine</subject><subject>Computed tomography</subject><subject>denosumab</subject><subject>Doxycycline</subject><subject>Immunotherapy</subject><subject>Jaw</subject><subject>medication‐related osteonecrosis of the jaw</subject><subject>Monoclonal antibodies</subject><subject>Mouthwashes</subject><subject>Osteolysis</subject><subject>Osteonecrosis</subject><subject>Osteoporosis</subject><subject>Patients</subject><subject>Periodontics</subject><subject>Teeth</subject><issn>0303-6979</issn><issn>1600-051X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kEtOwzAQhi0EoqWw4QDIEjukFD-S2GFXlfISEixAYmc5yaRNlcbBTlR1xxE4IyfBJYUls5lZfPOP5kPolJIx9XW5zBoYUyYl20NDGhMSkIi-7aMh4YQHcSKSATpybkkIFZzzQzRgSSgSwZMhWlxDbVy30unXx6eFSreQY-NaMDVk1rjSYVPgdgF4qde4MFVl1mU9x7Wp_YLr7LzMdIUbsKXJTd362cNWN5srPMGZdoAtNMa2x-ig0JWDk10fodeb2cv0Lnh8ur2fTh6DjLOQBZCLSOaEMwGp0CBjSkFGQEIegYCikCCBc1HIPOZANWM01KnMk4hGCc8jxkfovM9trHnvwLVqaTpb-5OKER4LzhIae-qip7Y_OguFamy50najKFFbqWorVf1I9fDZLrJLV5D_ob8WPUB7YF1WsPknSj1Mn2d96DeEz4T0</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Diniz‐Freitas, Márcio</creator><creator>Fernández‐Feijoo, Javier</creator><creator>Diz Dios, Pedro</creator><creator>Pousa, Xiana</creator><creator>Limeres, Jacobo</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0001-5349-1091</orcidid></search><sort><creationdate>201805</creationdate><title>Denosumab‐related osteonecrosis of the jaw following non‐surgical periodontal therapy: A case report</title><author>Diniz‐Freitas, Márcio ; Fernández‐Feijoo, Javier ; Diz Dios, Pedro ; Pousa, Xiana ; Limeres, Jacobo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3242-ed758d0327eb7ae8611e85e0435e7eff8e8e337f8d63e1a2214ab8d951593d523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Bevacizumab</topic><topic>Bisphosphonates</topic><topic>Case reports</topic><topic>Chlorhexidine</topic><topic>Computed tomography</topic><topic>denosumab</topic><topic>Doxycycline</topic><topic>Immunotherapy</topic><topic>Jaw</topic><topic>medication‐related osteonecrosis of the jaw</topic><topic>Monoclonal antibodies</topic><topic>Mouthwashes</topic><topic>Osteolysis</topic><topic>Osteonecrosis</topic><topic>Osteoporosis</topic><topic>Patients</topic><topic>Periodontics</topic><topic>Teeth</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Diniz‐Freitas, Márcio</creatorcontrib><creatorcontrib>Fernández‐Feijoo, Javier</creatorcontrib><creatorcontrib>Diz Dios, Pedro</creatorcontrib><creatorcontrib>Pousa, Xiana</creatorcontrib><creatorcontrib>Limeres, Jacobo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of clinical periodontology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Diniz‐Freitas, Márcio</au><au>Fernández‐Feijoo, Javier</au><au>Diz Dios, Pedro</au><au>Pousa, Xiana</au><au>Limeres, Jacobo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Denosumab‐related osteonecrosis of the jaw following non‐surgical periodontal therapy: A case report</atitle><jtitle>Journal of clinical periodontology</jtitle><addtitle>J Clin Periodontol</addtitle><date>2018-05</date><risdate>2018</risdate><volume>45</volume><issue>5</issue><spage>570</spage><epage>577</epage><pages>570-577</pages><issn>0303-6979</issn><eissn>1600-051X</eissn><abstract>Introduction
Osteonecrosis of the jaw associated with bisphosphonates is currently called medication‐related osteonecrosis of the jaw (MRONJ), given that in addition to bisphosphonates, jaw osteonecrosis has been related to the administration of other antiresorptive and antiangiogenic drugs, such as denosumab, sunitinib, bevacizumab and ipilimumab.
Case Presentation
A 77‐year‐old patient with osteoporosis treated with subcutaneous injections of denosumab at an interval of 6 months is presented. The patient developed MRONJ after receiving a non‐surgical periodontal therapy. Although the MRONJ was initially classified as a stage I lesion in this patient, cone beam computed tomography images confirmed the presence of a significant osteolytic lesion. Treatment consisted of the administration of chlorhexidine mouthwash and systemic doxycycline, exodontia of the involved teeth, sequestrectomy and complete surgical debridement of the necrotic bone.
Conclusion
To our knowledge, this is the first case reported in the literature of MRONJ following non‐surgical periodontal therapy in a patient with osteoporosis treated with denosumab. The risk of MRONJ development after a periodontal procedure and how to prevent this complication are still unknown.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>29479739</pmid><doi>10.1111/jcpe.12882</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5349-1091</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Bevacizumab Bisphosphonates Case reports Chlorhexidine Computed tomography denosumab Doxycycline Immunotherapy Jaw medication‐related osteonecrosis of the jaw Monoclonal antibodies Mouthwashes Osteolysis Osteonecrosis Osteoporosis Patients Periodontics Teeth |
| title | Denosumab‐related osteonecrosis of the jaw following non‐surgical periodontal therapy: A case report |
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