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Maluf, G., Caldas , RJ, Fregnani, ER et al. Kasus langka osteonekrosis rahang terkait bevacizumab terkait dengan implan gigi. Penyok Implan Int J 5, 34 (2019). https://doi.org/10.1186/s40729-019-0188-0 Unduh kutipan Diterima: 01 Juli 2019 Diterima: 30 Agustus 2019 Diterbitkan: 01 Oktober 2019 DOI: https://doi.org/10.1186/s40729-019-0188-0

Hak dan izin : Kasus langka osteonekrosis rahang t...

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Deklarasi etika : Kasus langka osteonekrosis rahan...

Persyaratan Deklarasi Helsinki dipatuhi, dan pasien memberikan persetujuan untuk semua tindakan bedah prosedur.Informed consent tertulis diperoleh dari pasien untuk publikasi laporan ini dan semua gambar yang menyertainya.Gustavo Maluf, Rogério Jardim Caldas, Eduardo Rodrigues Fregnani, dan Paulo Sérgio da Silva Santos menyatakan bahwa mereka tidak memiliki kepentingan yang bersaing.

Informasi penulis : Kasus langka osteonekrosis rah...

Klinik Swasta, Brasilia, DF, BrasilGustavo MalufBrasilia, BrasilGustavo MalufDepartment of Stomatology, Bauru Dental School, USP–University of São Paulo, Bauru, SP, BrazilRogério Jardim CaldasDepartemen Kedokteran Mulut, Rumah Sakit Sírio-Libanês, São Paulo, SP, BrasilEduardo Rodrigues FregnaniDepartment of Stomatology, Bauru Dental School, USP–University of São Paulo, Bauru, SP, BrazilP...

Ucapan Terima Kasih : Kasus langka osteonekrosis r...

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Referensi : Kasus langka osteonekrosis rahang terk...

Otto S, Schreyer C, Hafner S, dkk. Osteonekrosis rahang terkait bifosfonat—karakteristik, faktor risiko, gambaran klinis, lokalisasi, dan dampak pada pengobatan onkologis. J Craniomaxillofac Surg. 2012;40:303–9 .Agrillo A, Filiaci F, Ramieri V, dkk. Osteonekrosis rahang terkait bifosfonat (BRONJ): Pengalaman 5 tahun dalam pengobatan 131 kasus dengan terapi ozon. Eur Rev Med Pharmacol Sci. 2012...

Referensi : Kasus langka osteonekrosis rahang terk...

Pakosch D, Papadimas D, Munding J, dkk. Osteonekrosis mandibula karena agen anti-angiogenik, bevacizumab. Oral Maxillofac Surg. 2013;17:303–6. Corbella S, Taschieri S, Samaranayake L, Tsesis I, dkk. Pilihan perawatan implan setelah pencabutan gigi yang retak vertikal. Sebuah proposal untuk klasifikasi klinis defek tulang berdasarkan tinjauan sistematis literatur. Clin Implan Oral Res. 2014;25:9...

Referensi : Kasus langka osteonekrosis rahang terk...

Watters AL, Epstein JB, Agulnik M. Komplikasi oral dari terapi kanker yang ditargetkan: tinjauan literatur naratif. Oral Oncol. 2011;47:441–8. Herbst RS, O'Neill VJ, Fehrenbacher L, et al. Studi fase II tentang kemanjuran dan keamanan bevacizumab dalam kombinasi dengan kemoterapi atau erlotinib dibandingkan dengan kemoterapi saja untuk pengobatan kanker paru-paru sel kecil yang berulang atau re...

Abbreviations : Kasus langka osteonekrosis rahang ...

Osteonekrosis rahang terkait Bevacizumab Tulang meruncing Tomografi komputer Osteonekrosis rahang terkait pengobatan Faktor pertumbuhan endotel vaskular A

Ketersediaan data dan bahan : Kasus langka osteone...

Berbagi data tidak berlaku untuk artikel ini karena tidak ada kumpulan data yang dibuat atau dianalisis selama penelitian saat ini.

Kesimpulan : Kasus langka osteonekrosis rahang ter...

Temuan kasus ini menunjukkan bahwa pemasangan implan gigi merupakan faktor risiko osteonekrosis rahang pada pasien yang terpapar bevacizumab. Oleh karena itu, studi prospektif acak harus didorong untuk menentukan rejimen bevacizumab yang lebih aman yang mempertimbangkan baik operasi mulut dan risiko implan gigi untuk pengelolaan osteonekrosis dalam pengaturan klinis.

Discussion : Kasus langka osteonekrosis rahang ter...

MRONJ adalah efek samping obat dengan predileksi pada mandibula [24] , yang dapat dikaitkan dengan vaskularisasi mandibula yang relatif rendah dibandingkan dengan rahang atas [13] Infeksi gigi, intervensi bedah, pengobatan kortikosteroid, dan kemoterapi telah digambarkan sebagai faktor risiko osteonekrosis [25]. pasien mengalami osteonekrosis stadium 2 dengan infeksi gigi di area mandibula, bahkan...

Discussion : Kasus langka osteonekrosis rahang ter...

Pemberian agen antiangiogenik jangka panjang tidak secara langsung menunjukkan risiko tinggi MRONJ [16], meskipun beberapa penulis telah menetapkan interval 7-, 14-, dan 28 hari dari suspensi bevacizumab untuk bedah mulut [17,18,19] Dalam kasus ini, obat antiangiogenik dihentikan selama 28 hari sebelum penempatan implan; namun, ini tidak cukup untuk mencegah MRONJ. Permukaan implan Straumann® SLa...

Discussion : Kasus langka osteonekrosis rahang ter...

Sebuah meta-analisis menunjukkan bahwa penempatan implan gigi pada pasien yang terpapar bifosfonat tidak mengurangi tingkat keberhasilan implan gigi [11], meskipun pasien ini mungkin mengalami komplikasi Berdasarkan analisis ini, penilaian risiko harus dilakukan berdasarkan kasus per kasus, karena MRONJ jarang terjadi tetapi salah satu di antara komplikasi serius terapi bifosfonat [11] Namun, stud...

Presentasi kasus : Kasus langka osteonekrosis raha...

Lima minggu pascaoperasi, nyeri, drainase sekret purulen, dan tulang terbuka di sekitar implan diamati (Gbr. 4), meskipun tidak ada implan yang menunjukkan mobilitas. Sepuluh sesi terapi ozon yang terkait dengan levofloxacin dilakukan. Setelah 4 minggu terapi dengan minyak ozon (Philozon®, Balneário Cambori, SC, Brasil), tidak ada rasa sakit atau drainase dari sekresi purulen. Namun, sekuestrasi...

Presentasi kasus : Kasus langka osteonekrosis raha...

Seorang wanita bule berusia 54 tahun mengeluhkan rasa tidak enak dan nyeri di mulut. Riwayat medisnya termasuk kanker payudara dengan metastasis, yang didiagnosis pada tahun 2007. Pasien tidak memiliki penyakit penyerta dan tidak ada riwayat merokok. Telah dilakukan mastektomi radikal dengan diseksi aksila. Pasien tidak memiliki riwayat radioterapi kepala sebelumnya. dan leher atau penggunaan bifo...

Latar Belakang : Kasus langka osteonekrosis rahang...

Pengobatan keganasan sering kali melibatkan penggunaan terapi bertarget untuk mengontrol pertumbuhan dan kelangsungan hidup keganasan sel dengan mengganggu agen molekuler spesifik yang terlibat dalam karsinogenesis [1]. Bevacizumab adalah antibodi monoklonal manusiawi rekombinan yang dirancang untuk secara selektif mengikat dan menghambat aktivitas biologis semua isoform faktor pertumbuhan endotel...

Pendanaan : Kasus langka osteonekrosis rahang terk...

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Fig. 7. Panoramic radiograph at 7-month follow-up ...

Fig. 7. Panoramic radiograph at 7-month follow-up

Fig. 6. Image obtained 7 months postoperatively ...

Fig. 6. Image obtained 7 months postoperatively showing no lesions

Fig. 5. a, b Histological image of the lesion : A ...

Fig. 5. a, b Histological image of the lesion

Fig. 4. Bone exposure surrounding the implants wit...

Fig. 4. Bone exposure surrounding the implants with drainage of purulent secretion

Fig. 3. Panoramic radiograph after dental extracti...

Fig. 3. Panoramic radiograph after dental extractions with subsequent dental implants

Fig. 2. a, b Tomographic findings: lesions, measur...

Fig. 2. a, b Tomographic findings: lesions, measurements, and bone quality

Fig. 1. Initial clinical image showing oral infect...

Fig. 1. Initial clinical image showing oral infection foci

About this article : A rare case of bevacizumab-re...

Maluf, G., Caldas, R.J., Fregnani, E.R. et al. A rare case of bevacizumab-related osteonecrosis of the jaw associated with dental implants. Int J Implant Dent 5, 34 (2019). https://doi.org/10.1186/s40729-019-0188-0 Download citation Received: 01 July 2019 Accepted: 30 August 2019 Published: 01 October 2019 DOI: https://doi.org/10.1186/s40729-019-0188-0

Rights and permissions : A rare case of bevacizuma...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...

Additional information : A rare case of bevacizuma...

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Ethics declarations : A rare case of bevacizumab-r...

The requirements of the Helsinki Declaration were observed, and the patient gave informed consent for all surgical procedures. Written informed consent was obtained from the patient for the publication of this report and all accompanying images. Gustavo Maluf, Rogério Jardim Caldas, Eduardo Rodrigues Fregnani, and Paulo Sérgio da Silva Santos declare that they have no competing interests.

Author information : A rare case of bevacizumab-re...

Private Clinic, Brasília, DF, Brazil Gustavo Maluf Brasília, Brasil Gustavo Maluf Department of Stomatology, Bauru Dental School, USP–University of São Paulo, Bauru, SP, Brazil Rogério Jardim Caldas Department of Oral Medicine, Hospital Sírio-Libanês, São Paulo, SP, Brazil Eduardo Rodrigues Fregnani Department of Stomatology, Bauru Dental School, USP–University of São Paulo, Ba...

Funding : A rare case of bevacizumab-related osteo...

None

Acknowledgements : A rare case of bevacizumab-rela...

None

References : A rare case of bevacizumab-related os...

Otto S, Schreyer C, Hafner S, et al. Bisphosphonate-related osteonecrosis of the jaws—characteristics, risk factors, clinical features, localization and impact on oncological treatment. J Craniomaxillofac Surg. 2012;40:303–9. Agrillo A, Filiaci F, Ramieri V, et al. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): 5 year experience in the treatment of 131 cases with ozone therapy. Eur ...

References : A rare case of bevacizumab-related os...

Pakosch D, Papadimas D, Munding J, et al. Osteonecrosis of the mandible due to anti-angiogenic agent, bevacizumab. Oral Maxillofac Surg. 2013;17:303–6. Corbella S, Taschieri S, Samaranayake L, Tsesis I, et al. Implant treatment choice after extraction of a vertically fractured tooth. A proposal for a clinical classification of bony defects based on a systematic review of literature. Clin Oral I...

References : A rare case of bevacizumab-related os...

Watters AL, Epstein JB, Agulnik M. Oral complications of targeted cancer therapies: a narrative literature review. Oral Oncol. 2011;47:441–8. Herbst RS, O’Neill VJ, Fehrenbacher L, et al. Phase II study of efficacy and safety of bevacizumab in combination with chemotherapy or erlotinib compared with chemotherapy alone for treatment of recurrent or refractory none small-cell lung cancer. J Cli...

Abbreviations : A rare case of bevacizumab-related...

Bevacizumab-related osteonecrosis of the jaw Bone level tapered Computed tomography Medication-related osteonecrosis of the jaw Vascular endothelial growth factor A

Availability of data and materials : A rare case o...

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

Conclusions : A rare case of bevacizumab-related o...

The findings of the present case indicate that insertion of dental implants is a risk factor for osteonecrosis of the jaw in patients exposed to bevacizumab. Therefore, prospective randomized studies should be encouraged to determine a safer bevacizumab regimen that considers both oral surgeries and the risk of dental implants for the management of osteonecrosis in clinical settings.

Discussion : A rare case of bevacizumab-related os...

MRONJ is a side effect of drugs with a predilection for the mandible [24], which can be attributed to the relatively low vascularization of the mandible as compared to the maxilla [13]. Dental infections, surgical interventions, corticosteroid treatment, and chemotherapy have been described as risk factors for osteonecrosis [25]. In this case, the patient presented with stage 2 osteonecrosis with ...

Discussion : A rare case of bevacizumab-related os...

Long-term administration of antiangiogenic agents does not directly indicate a high risk of MRONJ [16], though some authors have established 7-, 14-, and 28-day intervals of bevacizumab suspension for oral surgery [17,18,19]. In this case, the antiangiogenic medication was suspended for 28 days before implant placement; however, this was not enough to prevent MRONJ. The surfaces of Straumann® S...

Discussion : A rare case of bevacizumab-related os...

A meta-analysis showed that the placement of dental implants in patients exposed to bisphosphonates did not reduce the success rate of the dental implant [11], although these patients may experience complications. Based on this analysis, a risk assessment should be performed on a case-by-case basis, since MRONJ is rare but one among serious complication of bisphosphonate therapy [11]. However, a c...

Case presentation : A rare case of bevacizumab-rel...

Five weeks postoperatively, pain, drainage of purulent secretion, and bone exposure around the implants were observed (Fig. 4), although none of the implants showed mobility. Ten ozone therapy sessions associated with levofloxacin were performed. After 4 weeks of therapy with ozone oil (Philozon®, Balneário Camboriú, SC, Brazil), no pain or drainage of purulent secretion were present. Bone s...

Case presentation : A rare case of bevacizumab-rel...

A 54-year-old Caucasian woman complained of an unpleasant taste and pain in the mouth. Her medical history included breast cancer with metastasis, which was diagnosed in 2007. The patient had no comorbidities and no history of smoking. A radical mastectomy with axillary dissection was performed. The patient had no previous history of radiotherapy of the head and neck or use of bisphosphonates. The...

Background : A rare case of bevacizumab-related os...

The treatment of malignancies often involves the use of targeted therapies to control the growth and survival of malignant cells by interfering with specific molecular agents involved in carcinogenesis [1]. Bevacizumab is a recombinant humanized monoclonal antibody designed to selectively bind and inhibit the biological activity of all human vascular endothelial growth factor (VEGF-A) isoforms. It...

Table 3 Frequency table of implant size : Prospect...

Implant size Frequency Percent 4.5 × 11 7 21.21 4...

Table 2 Frequency table of implant site : Prospect...

Implant site Frequency Percentage 15 2 6.06 14 ...

Table 1 Descriptive statistics (n = 16 patient...

Variable Number Mean (percentage) Standard deviation Age (years) 16 ...

About this article : Prospective cohort study of d...

May, M.C., Andrews, P.N., Daher, S. et al. Prospective cohort study of dental implant success rate in patients with AIDS. Int J Implant Dent 2, 20 (2016). https://doi.org/10.1186/s40729-016-0053-3 Download citation Received: 01 February 2016 Accepted: 12 July 2016 Published: 28 September 2016 DOI: https://doi.org/10.1186/s40729-016-0053-3

Rights and permissions : Prospective cohort study ...

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...

Author information : Prospective cohort study of d...

Triangle Implant Center, 5318 NC Highway 55, Suite 106, Durham, NC, 27713, USA Michael Clayton May & Uday Nitin Reebye University of North Carolina, Chapel Hill, NC, USA Paul Nielsen Andrews Boston University, Boston, MA, USA Shadi Daher You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this...

References : Prospective cohort study of dental im...

Kolhatkar S, Mason SA, Janic A, Bhola M, Haque S, Winkler JR. Surgical crown lengthening in a population with human immunodeficiency virus: a retrospective analysis. J Periodontol. 2012;83(3):344–53. Download references

References : Prospective cohort study of dental im...

United Nations AIDS Report. 2014. http://www.unaids.org/sites/default/files/media_asset/GARPR_2014_guidelines_en_0.pdf. Accessed 07 Oct 2015. Centers for Disease Control and Prevention: Statistics. 2013. http://www.cdc.gov/hiv/statistics/basics/index.html. Accessed 09 Oct 2015. Centers for Disease Control and Prevention: Statistics. 2011. http://www.cdc.gov/hiv/pdf/statistics_2011_hiv_surveillan...

Abbreviations : Prospective cohort study of dental...

Acquired immune deficiency syndrome Cluster of differentiation 4 Centers for Disease Control and Prevention Highly active antiretroviral therapy Human immunodeficiency virus Pneumocystis pneumonia

Conclusions : Prospective cohort study of dental i...

Our study found a slightly higher failure rate of 10 % in patients with AIDS, compared to widely accepted failure rates in healthy patients at 5–7 %. A cohort sample size of 33 may be considered small for statistical power; however, the results from this study could lead to larger future prospective cohort studies with additional funding to recruit a larger cohort and comparison groups. The ad...

Discussion : Prospective cohort study of dental im...

Regarding dental procedures, a retrospective cross-sectional study of 101 HIV patients was done from 2003 to 2005. Complication rate was found to be 2.2 % overall and 4.8 % after invasive dental procedures. No relationship was found between complications and immunological values [14]. Another study examining healing response after surgical crown lengthening in 21 patients with HIV was analyzed, ...

Discussion : Prospective cohort study of dental im...

Generally speaking, the use of antibiotics in dental implantology has been controversial. Amongst the reasons for early (preloading) implant failure are bacterial contamination, systemic disease, chemotherapy, overheating of bone, poor recipient site bone quality, and poor bone to implant contact upon surgery. After the prosthetic phase of the implant restoration, loading forces exceeding the bone...

Discussion : Prospective cohort study of dental im...

Since the AIDS epidemic reared its head in the 1980s, the nature of this disease has quickly evolved from a devastatingly debilitating disease to one of chronicity. These patients are requesting for and are entitled to the optimal restorative treatment plans, many of which include dental endosteal implants. Several authors have delved into the realm of implantology in the HIV-positive patient, but...

Results : Prospective cohort study of dental impla...

Descriptive statistics are presented in Table 1. Sixteen (n = 16) patients met our inclusion criteria and were included in our study. The sample included 12 males and 4 females. The mean age at enrollment was 36.2 years (sd 8.83 years). The mean CD4 count at the time of placement was 141.25 (sd 35.5). A total of 33 implants were placed in the 16 patients, including 5 mandibular implants and...

Methods : Prospective cohort study of dental impla...

Standard descriptive statistics were used to examine the distribution of key variables (age, gender, CD4 count at baseline and follow-up, and failure rate) in the sample. Due to the small sample size in this study (n = 16), the relationship of CD4 count and failure will be examined graphically and cases which failed are discussed individually in the “Results” section. A bar chart is presen...

Methods : Prospective cohort study of dental impla...

Our study is a prospective study looking at the failure rates in root-formed implants in AIDS patients at 5 years post-surgical placement of the implant fixtures. Patients recruited for the study had to meet inclusion criteria which included diagnosis of AIDS measured by a pre-operative cluster of differentiation 4 (CD4)

Background : Prospective cohort study of dental im...

The Joint United Nations Programme on HIV/AIDS estimates that 36.9 million (34.3–41.4 million) people are living with human immunodeficiency virus (HIV) infection [1]. In America, the Centers for Disease Control and Prevention (CDC) estimated that 1.2 million people aged 13 or older were HIV infected by the end of 2012 [2] and the cumulative population of persons surviving for more than 36 mont...

Abstract : Prospective cohort study of dental impl...

Oral health care of patients with acquired immune deficiency syndrome (AIDS) due to human immunodeficiency virus (HIV) is a growing area of concern, taking into consideration the increased life expectancy of patients resulting from antiretroviral therapy. There is insufficient literature regarding the impact of dental implants in AIDS patients. This study investigated the long-term clinical outcom...

Figure 2. Number of implants and failures by quart...

  Figure 2. Number of implants and failures by quartiles of CD4

Figure 1. Kaplan-Meier survival curve for individu...

  Figure 1. Kaplan-Meier survival curve for individual implants, n = 33

Table 3 Frequency table of implant size

Table 3 Frequency table of implant size Implant size Frequency Percent 4.5 × 11 7 21.21 4.5 × 8 1 3.03 4 × 11 10 30.3 4 × 8 13 39.39 5 × 11 1 3.03 5 × 8 1 3.03 Total 33 100

Table 2 Frequency table of implant site

Table 2 Frequency table of implant site Implant site Frequency Percentage 15 2 6.06 14 1 3.03 13 3 9.09 12 4 12.12 11 7 21.21 21 4 12.12 22 1 3.03 23 3 9.09 24 1 3.03 25 2 6.06 35 1 3.03 33 1 3.03 43 1 3.03 45 1 3.03 46 1 3.03 Total 33 100

Table 1 Descriptive statistics (n = 16 patient...

Table 1 Descriptive statistics (n = 16 patients) Variable Number Mean (percentage) Standard deviation Age (years) 16 36.19 8.83 Sex Male 12 (75) – Female 4 (25) – CD4 count (cells/mm3) 16 141.25 35.5 No. of implants 33 – – No. of implants that failed 3 (9.1) (% failed) – Average time to failure (days)   29.7 – ...

Discussion : Dental implant success rate in patien...

Discussion Since the AIDS epidemic reared its head in the 1980s, the nature of this disease has quickly evolved from a devastatingly debilitating disease to one of chronicity. These patients are requesting for and are entitled to the optimal restorative treatment plans, many of which include dental endosteal implants. Several authors have delved into the realm of implantology in the HIV-pos...

Results : Dental implant success rate in patients ...

Results Descriptive statistics are presented in Table 1. Sixteen (n = 16) patients met our inclusion criteria and were included in our study. The sample included 12 males and 4 females. The mean age at enrollment was 36.2 years (sd 8.83 years). The mean CD4 count at the time of placement was 141.25 (sd 35.5). A total of 33 implants were placed in the 16 patients, including 5 mandibular imp...

Methods: Dental implant success rate in patients w...

Methods Our study is a prospective study looking at the failure rates in root-formed implants in AIDS patients at 5 years post-surgical placement of the implant fixtures. Patients recruited for the study had to meet inclusion criteria which included diagnosis of AIDS measured by a pre-operative cluster of differentiation 4 (CD4)

Background: Dental implant success rate in patient...

Background The Joint United Nations Programme on HIV/AIDS estimates that 36.9 million (34.3–41.4 million) people are living with human immunodeficiency virus (HIV) infection. In America, the Centers for Disease Control and Prevention (CDC) estimated that 1.2 million people aged 13 or older were HIV infected by the end of 2012 and the cumulative population of persons surviving for more than 36...

Dental implant success rate in patients with AIDS

Abstract Background Oral health care of patients with acquired immune deficiency syndrome (AIDS) due to human immunodeficiency virus (HIV) is a growing area of concern, taking into consideration the increased life expectancy of patients resulting from antiretroviral therapy. There is insufficient literature regarding the impact of dental implants in AIDS patients. This study in...