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Photodynamic Therapy for Medication-Related Osteonecrosis of the Jaws: A Case Report

International Journal of Clinical Medicine 2016年第12期7卷 824-828页

作者： Mônica Simões Israel sarah aparecida antero Gisele Cuba Riche Giulianna Lima Pinheiro Mayara Leonel Duarte Meira Fernanda Vieira Heimlich Wagner Pinto das Chagas Nathália de Almeida Freire Maria Eliza Barbosa Ramos Rosemiro de Menezes Maciel School of Dentistry Rio de Janeiro State University Rio de Janeiro Brazil

Medication-related osteonecrosis of the jaws (MRONJ) is a relatively new disease. MARX reported first cases in 2003. MRONJ relates to oral and parenteral bisphosphonates as well as to the so-called target cancer therapies but the list of medications only grows. Although MRONJ is a relatively rare condition, it can be associated to significant morbidity with feeding limitations and intense pain. More severe cases can lead to potentially life-threatening infections. Every patient initiating bisphosphonate and/or target cancer therapy must visit a dentist before starting medication because preventive measures for MRONJ are much more effective compared to surgical management of the lesions. Surgical resolution can be especially difficult to obtain in the coexistence of certain complication factors like wider bone exposures, history of nitrogen containing bisphosphonates use (mainly zolendronate) and immunodeficiency. Recently, researchers have given attention to laser therapy associated to photosensitive agents as a possible option to management of some MRONJ lesions. Our case report demonstrates the use of photodynamic therapy in a denosumab related lesion in the mandible. It seems that denosumab related lesions are more amenable to treatment and total resolution because of the marked differences between its chemical and metabolic characteristics when compared to bisphosphonates.

关键词： Laser Phototherapy Osteonecrosis Jaws Denosumab

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Proximal Femoral Cortical Thickness and Medullary Canal Diameter in Soft and Hard Water Regions

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Open Journal of Orthopedics 2016年第3期6卷 58-62页

作者： Ahmed Elmorsy sarah Whitehouse John Timperley Stephen Veitch Royal Surrey County Hospital Guildford UK Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Australia Royal Devon & Exeter Hospital Exeter UK Salisbury district Hospital Salisbury UK

This study compared proximal femoral morphology in patients living in soft and hard water regions. The proximal femoral morphology of two groups of 70 patients living in hard and soft water regions with a mean age of 72.29 (range: 50 to 87 years) was measured using an antero-posterior radiograph of the non-operated hip with magnification adjusted. The medullary canal diameter at the level of the lesser trochanter (LT) was significantly wider in patients living in the hard water region (mean width: 1.9 mm wider;p = 0.003). No statistical significant difference was found in the medullary canal width at 10 cm below the level of LT, Dorr index, or Canal Bone Ratio (CBR). In conclusion, the proximal femoral morphology does differ in patients living in soft and hard water areas. These results may have an important clinical bearing in patients undergoing total hip replacement surgery. Further research is needed to determine whether implant survivorship is affected in patients living in hard and soft water regions.

关键词： Hip Hard Water Soft Water Femoral Cortical Thickening Medullary Diameter

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