amoxicillin-potassium-clavulanate-combination and Osteonecrosis

Sixteen patients with jaw biphosphonate-osteonecrosis and with exposed bone areas were subdivided into 2 treatment groups. The first group (7 patients) underwent superficial or radical surgical therapy, while the second (9 patients) underwent antibiotic treatment. A slight reduction of the necrotic areas was observed in 5 of 7 patients in the first group, whereas no change was observed in the remaining 2 patients at 22- and 24-month follow-up. A slight reduction of the necrotic areas was observed in 7 of 9 patients in the second group, whereas no change was observed in the remaining 2 patients at 5- and 24-month follow-up. The statistical analysis showed that the treatment regimen did not significantly influence the dimensional change in the exposed bone. The preliminary results seem to suggest that biphosphonate-associated osteonecrosis can be well controlled by a nonsurgical protocol consisting in long-term administration of antibiotics.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Analysis of Variance; Anti-Bacterial Agents; Bone Density Conservation Agents; Diphosphonates; Female; Humans; Imidazoles; Jaw Diseases; Linear Models; Male; Metronidazole; Middle Aged; Osteonecrosis; Pamidronate; Prospective Studies; Zoledronic Acid

Topics: Amoxicillin-Potassium Clavulanate Combination; Analgesics, Opioid; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Bacterial Infections; Dog Diseases; Dogs; Male; Meloxicam; Osteonecrosis; Thiazines; Thiazoles; Tramadol

Osteopetrosis is a heterogeneous disorder characterized by abnormal bone remodeling and increased bone density primarily due to defective osteoclast resorption. The diagnosis is based on a history of numerous fractures and radiological findings indicative of osteosclerosis, usually sufficient for a definitive diagnosis. We present a quite rare case of osteopetrosis complicated by recurrent episodes of maxillomandibular osteomyelitis associated with cutaneous fistulization and purulent nasal discharge. We used intravenous antibiotic therapy and necrotic bone debridement that prevented the appearance of acute infections over a 3-year follow-up, but the complete healing of the case was not achieved.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Cutaneous Fistula; Debridement; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Jaw Diseases; Nose Diseases; Osteomyelitis; Osteonecrosis; Osteopetrosis; Osteosclerosis; Recurrence

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.

Topics: Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bone Density Conservation Agents; Carcinoma; Chronic Disease; Debridement; Diphosphonates; Female; Follow-Up Studies; Humans; Imidazoles; Injections, Intravenous; Male; Maxillary Diseases; Maxillary Sinusitis; Middle Aged; Osteonecrosis; Osteoporosis; Osteotomy; Recurrence; Risk Factors; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Zoledronic Acid

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Bone Density Conservation Agents; Diphosphonates; Female; Follow-Up Studies; Humans; Imidazoles; Maxillary Diseases; Multiple Myeloma; Oroantral Fistula; Osteonecrosis; Zoledronic Acid

We report a patient with bisphosphonate-associated osteonecrosis of the jaws who developed pathological fractures of the upper and lower extremities after the suspension of treatment with bisphosphonates. Temporary discontinuation of the drugs does not alter the clinical course of the disease, and could result in the recurrence of bone pain and the progression of metastases or osteolytic lesions.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Infective Agents, Local; Bone Density Conservation Agents; Bone Neoplasms; Chlorhexidine; Debridement; Diphosphonates; Female; Humans; Hydrogen Peroxide; Imidazoles; Maxillary Diseases; Middle Aged; Mouthwashes; Multiple Myeloma; Oroantral Fistula; Osteonecrosis; Tooth Extraction; Zoledronic Acid