Switch to Dark theme

References

Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther. 2007; 29:1548-1558
Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O'Ryan F. American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw – 2014 Update. J Oral Maxillofac Surg. 2014; 72:1938-1956
Chrcanovic BR, Reher P, Sousa AA, Harris M. Osteoradionecrosis of the jaws – a current overview – part 1: Physiopathology and risk and predisposing factors. Oral Maxillofac Surg. 2010; 14:3-16
Patel V, Kelleher M, Sproat C, Kwok J, McGurk M. New cancer therapies and jaw necrosis. Br Dent J. 2015; 219:203-207
Haria S, Patel V, Sproat C, Kwok J, Ormondroyd L, McGurk M, Burke M, Reilly D, Lyons A, Cascarini L, Townley W. Is osteoradionecrosis evolving with improved radiotherapy delivery system?. J Oral Maxillofac Surg. 2016; 74
Crossman T, Herold J. Actinomycosis of the maxilla – a case report of a rare oral infection presenting in general dental practice. Br Dent J. 2009; 206:201-202
Gupta S, Sreenivasan V, Patil PB. Dental complications of herpes zoster: two case reports and review of literature. Indian J Dent Res. 2015; 26:214-219
Pogrel MA, Miller CE. A case of maxillary necrosis. J Oral Maxillofac Surg. 2003; 61:489-493
Lanigan DT, Hey JH, West RA. Aseptic necrosis following maxillary osteotomies: report of 36 cases. J Oral Maxillofac Surg. 1990; 48:142-156
Khan N, Memon W, Idris M, Ahmed M, Taufiq M. Post-traumatic near-complete aseptic necrosis of the maxilla: a case report and review of the literature. Dentomaxillofac Radiol. 2012; 41:429-431
Nguyen EV, Heggie AAC. Avascular necrosis of the midface secondary to disseminated intravascular coagulation. Int J Oral Maxillofac Surg. 2014; 43:1441-1444
Borle RM, Prasant MC, Badjate SJ, Patel IA. Sickle cell osteomyelitis of the maxilla: a case report. J Oral Maxillofac Surg. 2001; 59:1371-1373
Poghosyan YM, Hakobyan KA, Poghosyan AY, Avetisyan EK. Surgical treatment of jaw osteonecrosis in “Krokodil” drug addicted patients. J Craniomaxillofac Surg. 2014; 42:1639-1643
Alsufyani NA, Lam EW. Osseous (cemento-osseous) dysplasia of the jaws: clinical and radiographic analysis. J Can Dent Assoc. 2011; 77
Fenerty S, Shaw W, Verma R, Syed AB, Kuklani R, Yang J, Ali S. Florid cemento-osseous dysplasia: review of an uncommon fibro-osseous lesion of the jaw with important clinical implications. Skel Radiol. 2017; 46:581-590
Singer SR, Mupparapu M, Rnaggio J. Florid cementoosseous dysplasia and chronic diffuse osteomyelitis. Report of a simultaneous presentation and review of the literature. J Am Dent Assoc. 2005; 136:927-931
Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization Classification of Tumours. Pathology and Genetics Head and Neck Tumours.Lyon: IARC Press; 2005
MacDonald-Jankowski DS. Fibro-osseous lesions of the face and jaws. Clin Radiol. 2004; 59:11-25
Kawai T, Hiranuma H, Kishino M, Jikko A, Sakuda M. Cemento-osseous dysplasia of the jaws in 54 Japanese patients. A radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 87:107-114
MacDonald-Jankowski DS. Florid cemento-osseous dysplasia: a systematic review. Dentomaxillofac Radiol. 2003; 32:141-149
Hochberg MC. Racial differences in bone strength. Trans Am Clin Climatol Assoc. 118:305-315
Opazian RG. Osteomyelitis of jaws, 3rd edn. In: Topazian RG, Goldberg MH (eds). Philadelphia, PA: Saunders; 1994
Chen L, Li T, Jing W, Tang W, Tian W, Li C, Liu L. Risk factors of recurrence and life threatening complications for patients hospitalized with chronic suppurative osteomyelitis of the jaw. BMC Infect Dis. 2013; 13:1-8
Almazrooa SA, Woo S. Bisphosphonate and nonbisphosphonate-associated osteonecrosis of the jaw: A review. J Am Dent Assoc. 2009; 140:864-875
Weldon D. The effects of corticosteroids on bone: osteonecrosis (avascular necrosis of the bone). Ann Allergy Asthma Immunol. 2009; 103:91-97
Patel V, McGurk M. Use of pentoxifylline and tocopherol in radiation-induced fibrosis and fibroatrophy. Br J Oral Maxillofac Surg. 2017; 55:235-241
Henien M, Patel V, Sproat C, McGurk M. Spontaneous osteonecrosis of the maxilla. Dent Update. 2016; 43:563-566
Allen MR, Burr DB. The pathogenesis of bisphosphonate-related osteonecrosis of the jaw: so many hypotheses, so few data. J Oral Maxillofac Surg. 2009; 67:61-70
Toffanin A, Benetti R, Manconi R. Familial florid cemento-osseous dysplasia: a case report. J Oral Maxillofac Surg. 2000; 58
Wray L. The diabetic patient and dental treatment: an update. Br Dent J. 2011; 5:209-215
Khamaisi M, Regev E, Yarom N, Avni B, Leitersdorf E, Raz I, Elad S. Possible association between diabetes and bisphosphonate-related jaw osteonecrosis. J Clin Endocrinol Metab. 2007; 92:1172-1175
Kajizono M, Sada H, Sugiura Y, Soga Y, Kitamura Y, Matsuoka J, Sendo T. Incidence and risk factors of osteonecrosis of the jaw in advanced cancer patients after treatment with zoledronic acid or denosumab: a retrospective cohort study. Biol Pharmaceut Bull. 2015; 38:1850-1855
Manfredi M, Mergoni G, Goldoni M, Salvagni S, Merigo E, Meleti M, Vescovi P. A 5-year retrospective longitudinal study on the incidence and the risk factors of osteonecrosis of the jaws in patients treated with zoledronic acid for bone metastases from solid tumors. Med Oral Patol Oral Cir Bucal. 2017; 22:e342-e348

Cemento-Osseous dysplasia-related jaw necrosis − a case report and literature review

From Volume 46, Issue 1, January 2019 | Pages 62-67

Authors

Tasnim Atiea

BDS

Specialty Dentist (Oral Surgery), Department of Oral Surgery, Floor 23, Tower Wing, Guy's Dental Hospital, London Bridge, London, SE1 9RT, UK.

Articles by Tasnim Atiea

Marianne Henien

BDS(Hons), MFDS RCS(Ed)

Department of Oral Surgery, Guy's Dental Hospital (marianne.henien@gstt.nhs.uk)

Articles by Marianne Henien

Chris Sproat

BDS(Lond), MBBS(Hons), BSc(Hons), FDS RCS

Consultant (Oral Surgery), Oral Surgery Department, Floor 23, Guy's Dental Hospital, London Bridge, London, SE1 9RT, UK

Articles by Chris Sproat

Selvam Thavaraj

BDS, PhD, FDS RCS, FRCPath

Consultant (Oral Pathology), Department of Head and Neck Pathology, 4th Floor, Tower Wing, Guy's Dental Hospital, London Bridge, London, SE1 9RT, UK.

Articles by Selvam Thavaraj

Vinod Patel

BDS (Hons), PhD

Consultant (Oral Surgery), Oral Surgery Department, Guy's and St Thomas' NHS Foundation Trust, London

Articles by Vinod Patel

Email Vinod Patel

Abstract

Abstract: Osteonecrosis of the jaw (ONJ) is most commonly related to medications such as anti-resorptives and anti-angiogenics or head and neck radiotherapy. However, in addition to these, alternative causes of ONJ have also been reported including; infection, chemical toxicity, trauma and vascular ischaemia, but this list is not exhaustive.

It is well accepted that cemento-osseous dysplasia (COD) can increase the risk of infection, poor healing and osteomyelitis due to the reduced vascularity. However, necrotic and exposed COD has not been widely reported. This case report describes a patient with COD-related necrosis in the anterior mandible and hence provides an additional member to the ever growing list of potential predisposing factors for jaw necrosis

CPD/Clinical Relevance: Cemento-osseous dysplasia is a well recognized and benign condition commonly diagnosed from radiographs. The condition carries an increased risk of osteomyelitis and slow healing following oral surgery and, at its extreme, can cause osteonecrosis of the jaw, which remains an important condition of which the general dental practitioner (GDP) should be aware.

Article

Osteonecrosis of the jaw (ONJ) is identified as ‘non-healing exposed necrotic bone in the maxillofacial region’.1 This broad definition has been expanded with specific detail for the two most common causes of ONJ; medication-related osteonecrosis of the jaw (MRONJ)2 and osteoradionecrosis (ORN).3 Specifically, MRONJ is defined as exposed bone or bone which can be probed through an intra- or extra-oral fistula in the maxilla or mandible, persisting for more than 8 weeks, having previous treatment with anti-resorptive or anti-angiogenic medications and without a history of radiotherapy or metastatic disease.2 In contrast, there remains no agreed definition for ORN but a theme amongst the many definitions proposed is the requirement of exposed, necrotic jaw bone in patients who have undergone head and neck radiotherapy.3 The exact duration required for the bone to be exposed to be deemed ORN remains under debate.

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available

Already have an account? Sign in here