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Int. J. Oral Maxillofac. Surg. 2009; 38: 704–705 doi:10.1016/j.ijom.2009.02.006, available online at http://www.sciencedirect.com

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In Vivo Evaluation of Calcium Carbonate Bone Graft Substitutes

Osteonecrosis of the jaws by bisphosphonates. Report of 15 cases and therapeutic recommendations

A. Uraz, S.E. Gu¨ltekin, E. Barıs¸, Y. C ¸ apan, K. Eren J Dent Fac Gazi Uni 2007:24(2): 109–114 The aim of this study was to evaluate the biological adaptation and response of a new calcium carbonate bone graft material in immediate, medium and late periods. In this experimental animal study, 40 randomly selected three-month-old male guinea pigs were selected as the animal model. The study group received 1000 mm graft material both subperiostally into the critical size calvarial defects and subcutaneously into their dorsal sites. Similar bone defects were created as the sham control group. The guinea pigs were sacrificed on 5th, 14th, 45th and 60th days after surgery and block sections were prepared for histopathological and histochemical evaluation. Results showed that the level of graft material decreased with time and it was observed that the defects in 60th day group had more calcified tissue than the others. There were no complications recorded and that included abscess formation, necrosis, granulation tissue, ulceration, or foreign body reaction. According to the results of this study, the authors concluded that calcium carbonate graft material did not cause any unwanted reaction both in hard and soft tissues and thus claimed to be a suitable alternative bone substitute. REHA KISNISCI doi:10.1016/j.ijom.2009.02.007

0901-5027/060704 + 02 $36.00/0

I. Heras, I. Zubillaga, M. Castrillo, J.J. Montalvo Medicina Oral Patologia Oral y Cirugı´a Bucal 2007: 12: 210–214 The aim of this paper was to retrospectively study a group of patients affected by osteonecrosis of the jaws related to bisphosphonates administration. 15 patients, composing of 10 females (66,6 %) and 5 males (33,3%), were included in this study. Mean age was 64 years (range 41-75). All patients had been previously treated with bisphosphonates. Bisphosphonate therapies were used because of multiple myeloma in 5 cases, breast cancers in 5 cases, prostatic carcinoma in 3 cases and osteoporosis in 2 cases. Zoledronic acid was used in 13 cases (86.6%), while in 2 cases aledronate sodium was administered and in one case sodium pamidronate combined with zoledronic acid were used. Mandibular bone was affected in 10 cases (66.6%), both mandibular and maxillary bones were simultaneously affected in 3 cases (20%), while isolated maxillary bone was affected in 2 cases (13.3%). In 14 cases (93.3%), the initial clinical presentation was intra-oral bony exposure and one patient showed gingival granuloma associated with paraesthesia of the inferior alveolar nerve. Other associated complications included neurological disturbance in 3 cases (20%), cervical fistula in 3 cases (20%) and oro-antral fistula with maxillary sinusitis in 2 cases. One patient suffered pathologic mandibular fracture due weakening by the osteonecrosis. In 6 cases (40%), tooth extraction was identified before the onset of the osteonecrosis. Treatment of biphosphonate induced osteonecrosis was aimed to be conservative

initially. A combination of antibiotics and oral cleansing with chlorhexidine showed good clinical results in 7 cases (46.6%). Sequestrectomy of the exposed bone was performed in 5 cases (33%). In one case affected by oro-antral fistula, conservative surgical repair was carried out while in another case, segmentary maxillectomy and fistula repair by a local flap was done. In two cases of cervical fistula, alveolar mandibulectomy preserving the inferior mandibular border was performed. The pathological mandibular fracture case necessitated segmental mandibulectomy and no reconstruction was done. The authors concluded that all patients treated with bisphosphonates should have regular oro-maxillofacial evaluation. A conservative treatment approach is recommended. Further studies are needed to establish a consensus of treatment. JULIO ACERO doi:10.1016/j.ijom.2009.02.008

Thai Effect of music on the anxiety of the patients having surgical removal of impacted mandibular third molars K. Dhanesuan, C. Chanasriyothin, P. Chiasuwan, Y. Wongsasulaksana Thai J Oral Maxillofac Surg 2007: 21(2): 94–100 Forty-five patients receiving surgical removal of impacted mandibular third molars at the Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, were included in this music therapy study. The systolic and diastolic blood pressure and pulse rate were measured and the questionnaire on music therapy was completed by each patient. The mean systolic and diastolic blood pressures and pulse rate in the experimental group were slightly lower when compared with

# 2009 Published by Elsevier Ltd on behalf of International Association of Oral and Maxillofacial Surgeons.