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Master Thesis

Prise en charge au CHU de Poitiers des osteonécroses de la mâchoire secondaires aux anti-résorptifs osseux

Abstract : Background: drug-related osteonecrosis of the jaw (ONJ) was first described with biphosphonates in the 2000s. This adverse effect was then identified after exposure to other treatments involved in bone remodelling: mainly denosumab, and more rarely antiangiogenic drugs and immunomodulators. Despite this rare but serious side effect, these drugs have been proven to be effective in the management of benign and malignant bone tissue diseases. Methods: we presented the management of ONJ at different stages at the University Hospital of Poitiers in order to compare it to the latest international recommendations and to the data in the literature. Results: the therapeutic arsenal described in the recommendations of the different societies for all stages is similar. The conservative approach is favoured by the French (2013) and American (2014) societies, however, according to recent data in the literature (European Workshop 2019), surgical management with resection of the necrotic bone sequestrum in the earliest stages seems to show a better long-term prognosis. Our management at Poitiers University Hospital favours the surgical approach when the patient's general condition allows it. Conclusion: the difficulty in defining the stages of ONJ, as well as in treating them, explains the complexity of establishing an international consensus, despite a large number of published studies on the subject. Multidisciplinary management is necessary for good therapeutic decisions and to improve the quality of life of patients.
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Submitted on : Monday, October 11, 2021 - 3:37:05 PM
Last modification on : Tuesday, November 23, 2021 - 3:15:41 AM
Long-term archiving on: : Wednesday, January 12, 2022 - 8:11:32 PM


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  • HAL Id : dumas-03373612, version 1



Solène Menneteau. Prise en charge au CHU de Poitiers des osteonécroses de la mâchoire secondaires aux anti-résorptifs osseux. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03373612⟩



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