minocycline and Jaw-Diseases

Minocycline, a semi-synthetic tetracycline antibiotic, is well documented as being associated with pharmacogenic pigmentation of various tissues in humans and other mammals. The most obvious of these are skin pigmentation, but intraorally include "green" roots of erupted teeth, "black" roots of extracted teeth, a dark stain of the crowns of fully developed teeth, and "black" alveolar bone. This article presents five cases of "black" alveolar bone with photographic documentation of its progress. It also reviews the available English language literature on this phenomenon. The incidence of minocycline staining of alveolar bone is probably 2% of that population taking the drug for 2 months or longer. Presently, minocycline is most widely used in the young adult population for the treatment of acne. With the recent interest in minocycline as a palliative treatment for rheumatiod arthritis, an entirely different population could be experiencing this effect. If minocycline use becomes widespread as a treatment for rheumatoid arthritis, it is likely that more practitioners will be asked to diagnose this sometimes striking, though apparently benign, condition. Recognition of this condition will save the practitioner and the patient from unnecessary concern and surgery.

Topics: Acne Vulgaris; Adolescent; Adult; Alveolar Process; Anti-Bacterial Agents; Diagnosis, Differential; Female; Humans; Jaw Diseases; Middle Aged; Minocycline; Palate; Pigmentation Disorders

Management of medication-related osteone-crosis of the jaw (MRONJ) with active infection can be a serious challenge for clinicians. Based on Association of Oral and Maxillofacial Surgeons (AAOMS) recommendations, we have tested a modified treatment protocol using topical minocycline.. Five patients diagnosed with stage II or III MRONJ lesions were willing to consent to our protocol. In addition to conventional treatment as suggested by the AAOMS, such as, surgical debridement, chlorhexidine irrigation, and systemic antibiotics, we applied 10% minocycline to the lesions once a week for sustained local antibiotic delivery.. All five patients reported pain relief after the first minocycline application. Complete healing occurred in three patients; case three healed completely after the third application, one case continues to improve toward resolution and one withdraws due to other non-relevant medical problem.. In this study, we are reporting favorable results using a modified protocol with topical minocycline to treat MRONJ lesions.

Topics: Administration, Topical; Aged; Aged, 80 and over; Anti-Bacterial Agents; Carboxymethylcellulose Sodium; Drug Administration Schedule; Female; Humans; Jaw Diseases; Minocycline; Osteonecrosis; Treatment Outcome

Topics: Anti-Bacterial Agents; Humans; Jaw Diseases; Minocycline; Pigmentation Disorders; Tooth Discoloration

Oral pigmentation due to minocycline hydrochloride (Minocin) therapy is an unusual and infrequently reported side effect of the drug. This report describes a patient on long-term minocycline therapy who presented with gingival pigmentation. Upon surgical exploration, the gingiva was noted to be normal in color, but the underlying bone was deeply pigmented. Via fluorescent microscopy, minocycline deposition within the alveolar bone was demonstrated.

Topics: Adult; Alveolar Process; Gingival Diseases; Humans; Jaw Diseases; Male; Minocycline; Pigmentation Disorders; Tetracyclines