Extraction socket healing in rats treated with bisphosphonate : animal model for bisphosphonate related osteonecrosis of jaws in multiple myeloma patients

Aim: The aim of this study is to replicate both clinical and histological presentation of bisphosphonate induced osteonecrosis of the jaws (BONJ) in an animal model of the disease state. Successful recapitulation of a BONJlike indication in an animal model will be useful for studying pathogenesis, as well as prevention and treatment strategies for BONJ. Materials and Methods: Eighty (80) rats were prospectively and randomly divided into two groups; control group(40) and study group(40). All animals in study group, injected with a dose of 1 mg/kg dexamethasone (DX) subcutaneously on day 7, 14, or 21; and 1, 2, or 3 doses of 7.5 ?g/kg zoledronic acid (ZA) subcutaneously administered to coincide with the last day of DX. Half of the animals from each group underwent extraction of the left mandibular molars and the remaining animals underwent extraction of the left maxillary molars under pentobarbital-induced general anesthesia. All animals were euthanized twenty-eight (28) days following tooth extractions. Results: The amount of new bone trabecules as significantly decreased in bisphosphonate-dexamethasone (BPDX) treated sockets. Difference between both groups was found statistically significant (p=0,0001). There's no foreign body reaction in sockets of both groups and no significance difference observed for fibrosis (p=0,306). The necrosis scores were significantly higher in BP-DX treated sockets (p=0,015). The inflamation scores were significantly higher for study group (p=0,0001). Conclusion: This study provides preliminary observations for the development of an animal model of BONJ. But we think that there is need for other studies have only BP treated group and larger study population. © Medicina Oral S. L

Use of Cone-Beam Computerized Tomography for Evaluation of Bisphosphonate-Associated Osteonecrosis of the Jaws in an Experimental Rat Model

Background: Bisphosphonate-induced osteonecrosis of the jaw (BONJ) is a frequently reported complication. The aim of this study was to investigate the clinical and histopathological presentation of BONJ with the Hounsfield score and to evaluate the reliability of the score for determining necrosis in an animal model

Complication of Polymethylmethacrylate Bone Cement in the Mandible

Polymethylmethacrylate bone cements have been widely used in orthopedic surgery as well as in maxillofacial area. Despite the advantages, it is well known that acrylic bone cements may cause bone or soft tissue necrosis because of the properties of its components and polymerization. This clinical report presents an extensive necrosis of the mandible after the use of the acrylic bone cement to fill the cyst cavity. The purpose of this article was to alert the clinicians about the complications that may occur after the use of the polymethylmethacrylate-based bone cements

Combination of Medical and Surgical Treatments for Masseter Hypertrophy

Masseter hypertrophy (MH) is one of the uncommon conditions that swelling can be seen in the angular mandibular region of the face. The etiology of MH includes several factors, and various treatment methods are mentioned in the literature. Botulinum toxin type A application is most commonly used for the treatment because of its less invasive feature. As a surgical method, some treatment alternatives that aim to reduce muscle mass or reshape the bone tissue in the angular region are considered. In this case report, a 21-year-old male patient with unilateral masseter hypertrophy on the right side is presented. After the patient was diagnosed with MH, botulinum toxin treatment in two sessions at one-month intervals was done. Since the reduction in muscle volume was not in satisfactory dimensions after the botulinum toxin application, the masseter was reduced on the right side through an intraoral approach. At the same time, bone enlargements on each side of the angulus mandibula were reshaped and smoothened through an extraoral retro mandibular approach. Clinical and radiographic evaluation of the patient revealed more aesthetic and symmetrical appearance in the regular controls

Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy

Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth

Decompression, Enucleation, and Implant Placement in the Management of a Large Dentigerous Cyst

The dentigerous cyst is a developmental odontogenic cyst, accounting for 10% of all cysts of the jaws. The treatment options are decompression, marsupialization, or enucleation regarding the features of the lesions. In this article, a case of a 17-year-old adolescent girl having a large mandibular dentigerous cyst associated with an unerupted third molar is presented. The treatment is composed of decompression for 6 months and enucleation

Radiologic evaluation of an unusually sized complex odontoma involving the maxillary sinus by cone beam computed tomography

As a group, odontomas are the most common odontogenic neoplasms. This case report illustrates the benefits of cone beam computed tomography, in terms of treatment planning and surgical technique, to localize a large maxillary odontoma and accurately establish its relationship with the maxillary sinus and molar. (Quintessence Int 2009; 40: 533-535