title: Bisphosphonate-related osteonecrosis of the maxilla and sinusitis maxillaris.
abstract: Bisphosphonates (BPs) are widely used as bone-stabilizers, but side effects of BP therapy include bisphosphonate-related osteonecrosis of the jaw (BRONJ), which is resistant to therapy. The aim of this study was to evaluate the outcome of maxillary BRONJ involving sinusitis maxillaris. 21 patients presenting with maxillary BRONJ, from 2005 to 2008, were included in the study. In 18 cases BP had been administered for carcinoma and in 3 cases for osteoporosis, with an average exposure time of 47.4 months. 12 patients spontaneously developed BRONJ. The 10 patients diagnosed with stage III BRONJ presented with concomitant sinusitis maxillaris. Despite treatment, there were six recurrences of BRONJ, four of them with additional sinusitis maxillaris. Whether BRONJ occurred spontaneously or after extraction there was no difference in the outcome. Patients with advanced maxillary BRONJ often suffer from sinusitis maxillaris, both of which are frequently resistant to therapy.
authors.affiliation: Department of Oral and Plastic Maxillofacial Surgery, Ruhr-University, Bochum, Germany. peter.drmaurer@web.de
authors.forename: P
authors.initials: P
authors.lastname: Maurer
authors.forename: T
authors.initials: T
authors.lastname: Sandulescu
authors.forename: M S
authors.initials: MS
authors.lastname: Kriwalsky
authors.forename: A
authors.initials: A
authors.lastname: Rashad
authors.forename: S
authors.initials: S
authors.lastname: Hollstein
authors.forename: I
authors.initials: I
authors.lastname: Stricker
authors.forename: F
authors.initials: F
authors.lastname: Hölzle
authors.forename: M
authors.initials: M
authors.lastname: Kunkel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002277:Carcinoma / Q000188:drug therapy; D002908:Chronic Disease; D003646:Debridement; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects; D007275:Injections, Intravenous; D008297:Male; D008439:Maxillary Diseases / Q000139:chemically induced* / Q000628:therapy; D015523:Maxillary Sinusitis / Q000139:chemically induced* / Q000628:therapy; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced* / Q000628:therapy; D010024:Osteoporosis / Q000188:drug therapy; D010027:Osteotomy; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D019980:Amoxicillin-Potassium Clavulanate Combination