Clinical aspects of bisphosphonate-associated oral osteonecrosis: Patients and methods

We analysed the clinical data of 9 patients demanding treat­ment for maxillary bone necrosis of unknown origin, sent to us by the Haematology department of the “San Giacomo” Hospital of Rome. The 9 patients belong to a group of 54 patients (41F, 13M) who were under bisphosphonate treatment for multiple myeloma, osteoporosis, hyperparathyroidism and Paget’s dis­ease (Table I).

Table I – Group of analysed patients.

Diagnosis

Patient’s number

Asymptomatic myeloma

4

(3F, 1M)

Symptomatic myeloma

36

(28F, 8M)

Osteoporosis

8

(6F, 2M)

Hyperparathyroidism

4

(4F)

Paget’s disease

2

(2M)

Total

54

(41F, 13M)

Table II shows the clinical data of the 9 patients with maxil­lary osteonecrosis associated with bisphosphonate treat­ment. The group included 8 females and 1 male, with aver­age age 71 years (range 89-59) and affected for multiple myeloma (6 cases), chronic leukemia (1 case), osteoporosis (1 case) and Waldenstrom’s disease with osteoporosis (1 case). Average bisphosphonates treatment duration was 42 months (range 18-75). Oral manifestations were of upper maxillary osteonecrosis areas in 4 cases and mandibular le­sions in 5 cases. All patients were under observation be­cause of the presence of an infection in the exposed areas, with stinging and diffused pain that demanded systemic an­tibiotic treatment.
Having read all the information above and considered it carefully, our doctors recommend buying your drugs at the because this is where you always get most advantageous deals on the drugs required.

Table II – Demographics of 9 patients with bisphosphonates-associated oral cavity osteonecrosis.

Patient n.

Sex

Age

Systemic disease

Bisphosphonates

therapy

(months)

Oral manifestations (type/location)

Therapy

1

F

81

Multiple myeloma-k

Pamidronate (2) Zolendronate (27)

Osteonecrosis, infection/ mandible postextraction

Antibiotics, Rinses, Analgesics

2

F

58

Waldenstrom’s disease and severe osteoporosis

Pamidronate (59) Zolendronate (27)

Osteonecrosis, infection/ maxilla

Sequestrectomy, Hyperbaric oxigen therapy, Antibiotics

3

M

84

Multiple myeloma IgG-lamba

Zolendronate (18)

Osteonecrosis, infection/ maxilla postextraction

Sequestrectomy, Antibiotics

4

F

59

Multiple myeloma IgA-k

Pamidronate (75)

Osteonecrosis, infection/ mandible postextraction

Sequestrectomy, Hyperbaric oxigen therapy, Antibiotics

5

F

67

Multiple myeloma IgG-k

Pamidronate (13) Zolendronate (34)

Osteonecrosis, infection/ mandible postextraction

Sequestrectomy, Hyperbaric oxigen therapy, Antibiotics

6

F

70

Multiple myeloma IgG-k

Pamidronate (53) Zolendronate (27)

Osteonecrosis, infection/ maxilla

Antibiotics, Rinses

7

F

72

Severe osteoporosis with chronic lymphatic leukemia

Pamidronate (26) Zolendronate (20)

Osteonecrosis, infection/ mandible postextraction

Sequestrectomy, Hyperbaric oxigen therapy, Antibiotics

8

F

71

Severe osteoporosis

Pamidronate (3) Zolendronate (47)

Osteonecrosis/mandible

Antibiotics, Rinses

9

F

78

Multiple myeloma IgG-k

Pamidronate (20) Zolendronate (29)

Osteonecrosis, infection/ maxilla

Hyperbaric oxigen therapy, Antibiotics

About

So Many Advances in Medicine, So Many Yet to Come