Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition
Osteonecrosis of the jaws (ONJ) in osteoporosis patients has been defined as rare, but the number of reported cases is increasing. We report a case of delayed ONJ diagnosis in a patient, who was being treated with alendronate, developing bone alterations both in maxilla and in mandible. Underestimat...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2017-03-01
|
| Series: | Dentistry Journal |
| Subjects: | |
| Online Access: | http://www.mdpi.com/2304-6767/5/1/13 |
| _version_ | 1817992435379208192 |
|---|---|
| author | Mario Migliario Giovanni Mergoni Paolo Vescovi Iolanda De Martino Manuela Alessio Luca Benzi Filippo Renò Vittorio Fusco |
| author_facet | Mario Migliario Giovanni Mergoni Paolo Vescovi Iolanda De Martino Manuela Alessio Luca Benzi Filippo Renò Vittorio Fusco |
| author_sort | Mario Migliario |
| collection | DOAJ |
| description | Osteonecrosis of the jaws (ONJ) in osteoporosis patients has been defined as rare, but the number of reported cases is increasing. We report a case of delayed ONJ diagnosis in a patient, who was being treated with alendronate, developing bone alterations both in maxilla and in mandible. Underestimation of ONJ incidence and missed or delayed ONJ diagnosis in osteoporosis patients might derive from lack of awareness of health providers as well as from an ONJ definition that is too restricted. The more recent definition of medication-related osteonecrosis of the jaws (MRONJ) released in 2014 by the American Association of Oral Maxillofacial Surgeons (AAOMS) accept fistula, besides bone exposure, as a major sign of disease, but it seems to be insufficient since it excludes all cases of ONJ disease without bone exposure. A new MRONJ definition is needed to avoid missing or delayed diagnosis. |
| first_indexed | 2024-04-14T01:26:16Z |
| format | Article |
| id | doaj.art-701ff04563fa4459bfbfb235b809c362 |
| institution | Directory Open Access Journal |
| issn | 2304-6767 |
| language | English |
| last_indexed | 2024-04-14T01:26:16Z |
| publishDate | 2017-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Dentistry Journal |
| spelling | doaj.art-701ff04563fa4459bfbfb235b809c3622022-12-22T02:20:25ZengMDPI AGDentistry Journal2304-67672017-03-01511310.3390/dj5010013dj5010013Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ DefinitionMario Migliario0Giovanni Mergoni1Paolo Vescovi2Iolanda De Martino3Manuela Alessio4Luca Benzi5Filippo Renò6Vittorio Fusco7Dental Clinic, Health Sciences Department, University of Eastern Piedmont “A. Avogadro”, 28100, Novara, ItalyOral Medicine and Laser Surgery Unit, University Center of Dentistry, Department of Medicine and Surgery, University of Parma, 43121, Parma, ItalyOral Medicine and Laser Surgery Unit, University Center of Dentistry, Department of Medicine and Surgery, University of Parma, 43121, Parma, ItalyCentro di Documentazione Osteonecrosi dei Mascellari, 15121,Alessandria, ItalyCentro di Documentazione Osteonecrosi dei Mascellari, 15121,Alessandria, ItalyRadiology Unit, Alessandria Hospital, 15121, Alessandria, ItalyInnovative Research Laboratory for Wound Healing, Health Sciences Department, University of Eastern Piedmont “A. Avogadro”, 28100, Novara, ItalyCentro di Documentazione Osteonecrosi dei Mascellari, 15121,Alessandria, ItalyOsteonecrosis of the jaws (ONJ) in osteoporosis patients has been defined as rare, but the number of reported cases is increasing. We report a case of delayed ONJ diagnosis in a patient, who was being treated with alendronate, developing bone alterations both in maxilla and in mandible. Underestimation of ONJ incidence and missed or delayed ONJ diagnosis in osteoporosis patients might derive from lack of awareness of health providers as well as from an ONJ definition that is too restricted. The more recent definition of medication-related osteonecrosis of the jaws (MRONJ) released in 2014 by the American Association of Oral Maxillofacial Surgeons (AAOMS) accept fistula, besides bone exposure, as a major sign of disease, but it seems to be insufficient since it excludes all cases of ONJ disease without bone exposure. A new MRONJ definition is needed to avoid missing or delayed diagnosis.http://www.mdpi.com/2304-6767/5/1/13bisphosphonatealendronateosteoporosisosteonecrosis of jawBRONJMRONJlaser therapy |
| spellingShingle | Mario Migliario Giovanni Mergoni Paolo Vescovi Iolanda De Martino Manuela Alessio Luca Benzi Filippo Renò Vittorio Fusco Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition Dentistry Journal bisphosphonate alendronate osteoporosis osteonecrosis of jaw BRONJ MRONJ laser therapy |
| title | Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition |
| title_full | Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition |
| title_fullStr | Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition |
| title_full_unstemmed | Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition |
| title_short | Osteonecrosis of the Jaw (ONJ) in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition |
| title_sort | osteonecrosis of the jaw onj in osteoporosis patients report of delayed diagnosis of a multisite case and commentary about risks coming from a restricted onj definition |
| topic | bisphosphonate alendronate osteoporosis osteonecrosis of jaw BRONJ MRONJ laser therapy |
| url | http://www.mdpi.com/2304-6767/5/1/13 |
| work_keys_str_mv | AT mariomigliario osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT giovannimergoni osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT paolovescovi osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT iolandademartino osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT manuelaalessio osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT lucabenzi osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT filipporeno osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition AT vittoriofusco osteonecrosisofthejawonjinosteoporosispatientsreportofdelayeddiagnosisofamultisitecaseandcommentaryaboutriskscomingfromarestrictedonjdefinition |