Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaws (MRONJ) – formerly referred to as bisphosphonate-related osteonecrosis of the jaws ...(BRONJ)—were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007, 2009 and 2014. The position papers were developed by a committee appointed by the AAOMS Board of Trustees and comprising clinicians with extensive experience in caring for these patients, as well as clinical and basic science researchers. The knowledge base and experience in addressing MRONJ continues to evolve and expand, necessitating modifications and refinements to the previous position papers. Three members of the AAOMS Committee on Oral, Head, and Neck Oncologic and Reconstructive Surgery (COHNORS) and three authors of the 2014 position paper were appointed to serve as a working group to analyze the current literature and revise the guidance as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis and management strategies and highlights the current research status. AAOMS maintains that it is vitally important for this information to be disseminated to other relevant healthcare professionals and organizations.
Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaw (MRONJ) were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) ...position papers in 2007 and 2009. The position papers were developed by a special committee appointed by the board and composed of clinicians with extensive experience in caring for these patients and basic science researchers. The knowledge base and experience in addressing MRONJ has expanded, necessitating modifications and refinements to the previous position paper. This special committee met in September 2013 to appraise the current literature and revise the guidelines as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis, staging, and management strategies and highlights current research status. The AAOMS considers it vitally important that this information be disseminated to other relevant health care professionals and organizations.
This article provides the best current frequency estimate of medication-related osteonecrosis of the jaws (MRONJ), and identifies factors associated with the risk of developing osteonecrosis of the ...jaw (ONJ) among patients exposed to relevant medications (ie, antiresorptive or antiangiogenic agents). MRONJ is a rare but serious complication of cancer treatment or osteoporosis management. This review confirms that antiresorptive medications such as oral or intravenous bisphosphonates and denosumab are the most common risk factors for developing ONJ. The risk of MRONJ is greater in patients with cancer than in those receiving antiresorptive treatments for osteoporosis by a factor of 10.
Purpose Bisphosphonates (BPs) effectively treat metastatic bone disease, hypercalcemia, and osteoporosis. BP exposure, however, may be associated with osteonecrosis of the jaw (ONJ). The aim of the ...present study was to estimate the magnitude of the association between intravenous (IV) BP exposure and ONJ, and to identify potential confounders. Materials and Methods Using a case-control study design, the investigators identified and adjudicated a sample of cases with ONJ and matched them randomly with 5 controls per case. The controls were matched to cases on age, gender, cancer type, and date of cancer diagnosis. The medical records were abstracted and data on BP exposure, cancer therapy, and comorbidities were recorded. Statistical analyses were carried out using conditional logistic regression in Stata 9.0 (Stata Corp, College Station, TX). Results Thirty cases of ONJ were identified at Massachusetts General Hospital from February 2003 through February 2007. Zoledronate was found to confer significant risk toward development of ONJ (adjusted odds ratio = 31.8, P < .05). Although a trend toward increased risk was noted for pamidronate, this association was not significant after controlling for zoledronate. Obesity and smoking were associated significantly with ONJ development, whereas oral BPs had no effect. Conclusion In this study, cancer patients who had received zoledronate exhibited a significant 30-fold increase in their risk to develop ONJ. More studies are needed to elucidate the exact role of obesity and smoking in the development of ONJ, and the complex interactions of IV BPs with other chemotherapies during cancer treatment.
Abstract Purpose Citation rate is one of several tools to measure academic productivity. The purposes of this study were to estimate and identify factors associated with citation rates in the oral ...and maxillofacial surgery (OMS) literature. Materials and Methods This was a retrospective longitudinal study of publications in the Journal of Oral and Maxillofacial Surgery , International Journal of Oral and Maxillofacial Surgery , and Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology, from January – December 2012. The predictor variables were author- and article-specific factors. The outcome variable was the citation rate, defined as the total number of citations for each article over a four-year period. Descriptive, bivariate, and multiple regression statistics were computed. Results The authors identified 993 articles published during 2012. The mean number of citations at 4-years post-publication was 5.6 + 5.3 (median = 4). In bivariate analyses, several author-specific and article-specific factors were associated with citation rates. In a multiple regression model, adjusting for potential confounders/effect modifiers, first author H-index, number of authors, journal, OMS focus area, and Oxford level of evidence were significantly associated with citation rate (p < 0.002). Conclusion The investigators identified five factors associated with citation rates in OMS. These factors should be considered in context when evaluating citation-based metrics for OMS. Studies that focus on core OMS procedures (e.g. dentoalveolar surgery, dental implant surgery), are published in specialty-specific journals (e.g. JOMS or IJOMS), and have higher levels of evidence are more likely to be cited.
NRF2, a transcription factor that has been deemed the master regulator of cellular redox homeostasis, declines with age. NRF2 transcriptionally upregulates genes that combat oxidative stress; ...therefore, loss of NRF2 allows oxidative stress to go unmitigated and drive the aging phenotype. Oxidative stress is a common theme among the key features associated with the aging process, collectively referred to as the “Hallmarks of Aging”, as it disrupts proteostasis, alters genomic stability, and leads to cell death. In this review, we outline the role that oxidative stress and the reduction of NRF2 play in each of the Hallmarks of Aging, including how they contribute to the onset of neurodegenerative disorders, cancer, and other age-related pathologies.
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•NRF2 plays a role in each of the Hallmarks of Aging.•Decreased NRF2 expression contributes to the aging process.•Neurodegeneration, cancer, and other age-related pathologies are a result of lower NRF2 levels and increased oxidative stress.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The purposes of this report are to 1 ) summarize the epidemiologic evidence supporting an association between intravenous bisphosphonate (BP) exposure and BP-related osteonecrosis of the jaws ...(BRONJ), 2 ) identify measurable risk factors associated with BRONJ, and 3 ) assess the risk of BRONJ for patients receiving intravenous BPs to manage osteoporosis. The results of this review suggest a compelling, circumstantial association between intravenous BP exposure and BRONJ. The factors consistently associated with an increased risk of BRONJ included intravenous BP exposure in the setting of malignancy and dentoalveolar procedures. Finally, intravenous BP therapy for osteoporosis does not measurably increase the risk of BRONJ among postmenopausal women.
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