%0 Journal Article
%T A Rare Case of Epidermoid Carcinoma on Mandibular Osteonecrosis Due to Oral Bisphosphonates in the Treatment of Osteoporosis. Case Report and Review of Literature
%A Cariati P
%A P¨¦rez de Perceval Tara M
%A Rodr¨ªguez Ismael
%A S¨¢nchez L¨®pez JD
%J International Journal of Rheumatology | Rheumatology Journals Indexed in PubMed
%D 2018
%R http://dx.doi.org/10.15226/2475-4676/3/1/00135
%X Bisphosphonates (BP) are a group of synthetic analogs of inorganic pyrophosphate. They are used intravenously in the treatment of bone metastases of solid tumors and orally in the treatment of numerous rheumatic diseases, including osteoporosis [1]. Its mechanism of action is manifold, with recent published studies recognizing: inhibition of osteoclastic bone resorption, induction of osteoblasts to the secretion of an osteoclastmediated inhibition of bone formation, induction of apoptosis in osteoclast (¡°programmed cell death¡±), an antiangiogenic effect that reduces endothelial growth factor (EFG). Also, associated with the previous ones, there is an alteration of the macrophages and the cicatrization of the oral mucosa by involvement of the fibroblasts and keratinocytes [2]. Maxillary Osteonecrosis (BRONJ) associated with the use of intravenous BP in the treatment of bone metastases of solid tumors was first described by Ruggiero in 2004 [3]. The diagnostic classification of this entity was initially proposed in 2009 [4]. It has been recently modified in 2014, expanding to other anti-reabsorbing bone and antiangiogenic drugs [5]. Intraoral and oropharyngeal carcinomas have as their main risk factors alcohol, tobacco and human papillomavirus infection, especially the high risk oncogenic genotypes 16 and 18. All these factors may act separately or synergistically [6]. In the present study, we report a rare case of BRONJ induced by oral BP in the treatment of osteoporosis and its subsequent evolution towards squamous cell carcinoma. Key words: Mandibular Osteonecrosis; Osteoporosis; Epidermoid Carcinom
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