Background: Bisphosphonates are compounds similar to inorganic pyrophosphates, with anti-angiogenic, anti-inflammatory, anti-bone resorption, and antitumor effects. They are used to prevent bone metastases in cancer a...Background: Bisphosphonates are compounds similar to inorganic pyrophosphates, with anti-angiogenic, anti-inflammatory, anti-bone resorption, and antitumor effects. They are used to prevent bone metastases in cancer and treat osteoporosis. However, a major side effect is osteonecrosis of the jaw (ONJ), first reported in 2003, which is the exposure of necrotic bone in the mouth, often accompanied by infection. Prevention and treatment of ONJ remain challenging due to a lack of reliable epidemiological data on its incidence and risk factors. The aim of our work is to estimate the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to analyze its correlations with different risk factors reported in the literature. Methods: A retrospective observational study was conducted in the Oncology, Rheumatology and Maxillofacial Surgery Department of the Mohamed VI University Hospital;Marrakech, based on complete medical records during the period 2017 to 2022, as well as consultations of patients under bisphosphonates in these departments during July and August 2022. Statistical analysis was performed using IBM SPSS version 16.0. Results: Of the 107 patients included in this study, 60.7% were women, and 56.1% were between 40 and 65 years old. 100% of the patients suffered from a general pathology. Regarding treatment with BP, 103 patients were treated with Zoledronate, 4 with Risedronate, and 5 with Ibandronate. 103 patients received this treatment intravenously, while 4 patients received it orally. Regarding Oral health, only 12.1% of patients reported a poor oral health. 99.1% of patients were informed of the need for oral preparation prior to BP treatment, but only 71.02% received dental treatment, mainly tooth extraction. None of the patients were diagnosed with BRONJ. Conclusions: While the global incidence of ONJ ranges from 0.8% to 12%, our finding is zero. Most previous studies are retrospective with limited patient numbers like our study. To accurately assess the prevalence of ONJ, further prospective epidemiological studies with standardized protocols and thorough follow-up over several years are essential.展开更多
Objective: To study the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to determine the risk factors associated with the occurrence of this pathology. Method: An observational retrospective ...Objective: To study the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to determine the risk factors associated with the occurrence of this pathology. Method: An observational retrospective study was conducted in the Department of Oncology, Rheumatology, and Maxillofacial Surgery of Ibn Rochd University Hospital, Casablanca. The study utilized complete medical records from 2014 to 2022 and included consultations of patients receiving bisphosphonates (BPs) in July and September 2022. Statistical analysis was performed using SPSS version 16.0. Results: Our study population comprised 104 patients, of whom 91% were women and 49% were over 65 years old. Seventy-two percent of patients had a general pathology. Among them, 64 patients were treated with zoledronate, 43 with alendronate, and the remainder with risedronate, ibandronate, and pamidronate. The most common indications for treatment were bone metastasis following breast cancer (29.8%) and osteoporotic fractures (19.2%). Sixty-seven patients received intravenous (IV) treatment;only 10.5% exhibited good oral health. Fifty percent of patients underwent dental treatment, primarily tooth extractions. Osteonecrosis of the jaw (ONJ) was diagnosed in 1.9% of patients, predominantly in stages 1 and 2. Conclusion: Second and third-generation bisphosphonates are more strongly associated with the development of ONJ. Risk factors include monthly IV administration, poor oral health, comorbidities such as diabetes, medications like corticosteroids, invasive dental procedures, and not only oncological conditions but also rare indications such as bone algodystrophy. Nevertheless, our observed prevalence of 1.9% aligns with international rates ranging from 0.8% to 12%. However, most of the studies that have been carried out have been retrospective studies with insufficient numbers of patients. Further prospective epidemiological studies based on standardized protocols with rigorous and appropriate follow-up over several years are essential to determine the exact prevalence of ONJ.展开更多
In oral health care, the spread of harmful infectious agents from the oral cavity is a constant concern. The aim of this study was to evaluate the possibility of cross-contamination between patients due to the backflo...In oral health care, the spread of harmful infectious agents from the oral cavity is a constant concern. The aim of this study was to evaluate the possibility of cross-contamination between patients due to the backflow of biological fluids and contaminated aerosols into the water tubes of rotating instruments (high-speed turbines). A second aim was to assess the dispersion of the aerosols generated in the medical environment and the risk of contamination for the dentist. Materials and methods: For safety reasons, we carried out an experimental study on two sheep heads purchased from a butcher to simulate periodontal treatment in the two oral cavities. The first cavity was artificially contaminated with the reference strain of Staphylococcus aureus to assess the transfer of this bacteria from one cavity to the other through the waterlines of the high-speed turbine used. Results: The study revealed a worrying risk of cross-contamination from contaminated aerosols flowing back through the dental turbine into the dental unit waterlines (33.33%) [p S. aureus and total heterotrophic bacteria (THB) were dispersed at varying distances from the oral cavity. In particular, the highest contamination levels were found within 0.3 m of the patient for S. aureus (M = 43.66, SD = 1) and THB (M = 45.59, SD = 5), with contamination levels decreasing at a distance of 1.5 m, respectively (M = 5.63, SD = 3.61;M = 8.09, SD = 7.01) [p ≤ 0.05]. Conclusions: Procedures should be implemented to limit the risk of cross-contamination during dental treatment. This can be achieved by strict adherence to hygiene and asepsis measures in the dental unit and medical devices, compliance with regulatory standards (e.g., ISO 15883 1-2), and the installation of anti-retraction valves in dental turbines, dental chair unit and suction systems to prevent backflow of contaminated biological fluids and aerosols.展开更多
文摘Background: Bisphosphonates are compounds similar to inorganic pyrophosphates, with anti-angiogenic, anti-inflammatory, anti-bone resorption, and antitumor effects. They are used to prevent bone metastases in cancer and treat osteoporosis. However, a major side effect is osteonecrosis of the jaw (ONJ), first reported in 2003, which is the exposure of necrotic bone in the mouth, often accompanied by infection. Prevention and treatment of ONJ remain challenging due to a lack of reliable epidemiological data on its incidence and risk factors. The aim of our work is to estimate the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to analyze its correlations with different risk factors reported in the literature. Methods: A retrospective observational study was conducted in the Oncology, Rheumatology and Maxillofacial Surgery Department of the Mohamed VI University Hospital;Marrakech, based on complete medical records during the period 2017 to 2022, as well as consultations of patients under bisphosphonates in these departments during July and August 2022. Statistical analysis was performed using IBM SPSS version 16.0. Results: Of the 107 patients included in this study, 60.7% were women, and 56.1% were between 40 and 65 years old. 100% of the patients suffered from a general pathology. Regarding treatment with BP, 103 patients were treated with Zoledronate, 4 with Risedronate, and 5 with Ibandronate. 103 patients received this treatment intravenously, while 4 patients received it orally. Regarding Oral health, only 12.1% of patients reported a poor oral health. 99.1% of patients were informed of the need for oral preparation prior to BP treatment, but only 71.02% received dental treatment, mainly tooth extraction. None of the patients were diagnosed with BRONJ. Conclusions: While the global incidence of ONJ ranges from 0.8% to 12%, our finding is zero. Most previous studies are retrospective with limited patient numbers like our study. To accurately assess the prevalence of ONJ, further prospective epidemiological studies with standardized protocols and thorough follow-up over several years are essential.
文摘Objective: To study the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to determine the risk factors associated with the occurrence of this pathology. Method: An observational retrospective study was conducted in the Department of Oncology, Rheumatology, and Maxillofacial Surgery of Ibn Rochd University Hospital, Casablanca. The study utilized complete medical records from 2014 to 2022 and included consultations of patients receiving bisphosphonates (BPs) in July and September 2022. Statistical analysis was performed using SPSS version 16.0. Results: Our study population comprised 104 patients, of whom 91% were women and 49% were over 65 years old. Seventy-two percent of patients had a general pathology. Among them, 64 patients were treated with zoledronate, 43 with alendronate, and the remainder with risedronate, ibandronate, and pamidronate. The most common indications for treatment were bone metastasis following breast cancer (29.8%) and osteoporotic fractures (19.2%). Sixty-seven patients received intravenous (IV) treatment;only 10.5% exhibited good oral health. Fifty percent of patients underwent dental treatment, primarily tooth extractions. Osteonecrosis of the jaw (ONJ) was diagnosed in 1.9% of patients, predominantly in stages 1 and 2. Conclusion: Second and third-generation bisphosphonates are more strongly associated with the development of ONJ. Risk factors include monthly IV administration, poor oral health, comorbidities such as diabetes, medications like corticosteroids, invasive dental procedures, and not only oncological conditions but also rare indications such as bone algodystrophy. Nevertheless, our observed prevalence of 1.9% aligns with international rates ranging from 0.8% to 12%. However, most of the studies that have been carried out have been retrospective studies with insufficient numbers of patients. Further prospective epidemiological studies based on standardized protocols with rigorous and appropriate follow-up over several years are essential to determine the exact prevalence of ONJ.
文摘In oral health care, the spread of harmful infectious agents from the oral cavity is a constant concern. The aim of this study was to evaluate the possibility of cross-contamination between patients due to the backflow of biological fluids and contaminated aerosols into the water tubes of rotating instruments (high-speed turbines). A second aim was to assess the dispersion of the aerosols generated in the medical environment and the risk of contamination for the dentist. Materials and methods: For safety reasons, we carried out an experimental study on two sheep heads purchased from a butcher to simulate periodontal treatment in the two oral cavities. The first cavity was artificially contaminated with the reference strain of Staphylococcus aureus to assess the transfer of this bacteria from one cavity to the other through the waterlines of the high-speed turbine used. Results: The study revealed a worrying risk of cross-contamination from contaminated aerosols flowing back through the dental turbine into the dental unit waterlines (33.33%) [p S. aureus and total heterotrophic bacteria (THB) were dispersed at varying distances from the oral cavity. In particular, the highest contamination levels were found within 0.3 m of the patient for S. aureus (M = 43.66, SD = 1) and THB (M = 45.59, SD = 5), with contamination levels decreasing at a distance of 1.5 m, respectively (M = 5.63, SD = 3.61;M = 8.09, SD = 7.01) [p ≤ 0.05]. Conclusions: Procedures should be implemented to limit the risk of cross-contamination during dental treatment. This can be achieved by strict adherence to hygiene and asepsis measures in the dental unit and medical devices, compliance with regulatory standards (e.g., ISO 15883 1-2), and the installation of anti-retraction valves in dental turbines, dental chair unit and suction systems to prevent backflow of contaminated biological fluids and aerosols.
