title: Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report.
abstract: Adequate nutrition is imperative for a successful outcome in dialysis patients. Excellent oral hygiene and an efficient mastication can help to correct several metabolic and endocrine disturbances as well as delay initiation of dialysis in patients with chronic renal failure. However, concerns exist about the risk of malnutrition and protein depletion. On the other hand, intravenous bisphosphonates are the current standard of care for the treatment of hypercalcemia of malignancy and for the prevention of skeletal complications associated with bone metastases. Recently, retrospective case studies have reported an association between long-term bisphosphonate therapy and osteonecrosis of the jaws. This complication occurs either spontaneously or after minor dento-alveolar surgery including extraction of teeth. A malnourished dialysis patient who showed the typical clinical features of bisphosphonate-related osteonecrosis of the jaw (BRONJ) without any obvious radiological changes in his panoramic radiograph is reported. To minimize the risk of BRONJ, patients initiated on bisphosphonates should optimize routine dental care and have their baseline oral health evaluated by both clinical and radiographic examinations before initiation of bisphosphonate therapy.
authors.affiliation: Ege University, Ataturk Medical Vocabilitary School, Bornova, Izmir, Turkey.
authors.forename: Gulcan
authors.initials: G
authors.lastname: Coskun Akar
authors.forename: Candan
authors.initials: C
authors.lastname: Efeoglu
authors.forename: Alper
authors.initials: A
authors.lastname: Alp
authors.forename: Kutsi
authors.initials: K
authors.lastname: Koseoglu
authors.forename: Haluk
authors.initials: H
authors.lastname: Erol
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Yenicerioglu
authors.forename: Harun
authors.initials: H
authors.lastname: Akar
mesh_terms: D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods*; D009910:Oral Hygiene / Q000379:methods*; D010166:Palliative Care / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000658:Amoxicillin