[Oradlist] mail survey

Tue May 5 12:00:01 PDT 2009

"But certainty generally is illusion, and repose is not the destiny of man." 
I have extracted this from the address delivered by Oliver Wendell Holmes at 
the dedication of the hall of the Boston University School of Law on January 
8, 1897.
With apologies and salutations to Bernard Friedland, fellow radiologist and 
lawyer who lives in Massachusetts; and kindest regards to all who make 
Oradlist such a great forum for discussion!
----- Original Message ----- 
From: "Allan G Farman" <agfarm01 at louisville.edu>
To: "Oral Radiology Discussion Group" <oradlist at lists.ucla.edu>
Sent: Tuesday, May 05, 2009 11:19 PM
Subject: Re: [Oradlist] mail survey


> There are too many "experts" or "gurus" on the "weekend warier" and State 
> Meeting speaking circuit providing  courses that are accredited for CE 
> credits despite lacking any semblance of scientific evidence. Often 
> continuing education does more harm than good.
>
>
>
> Allan G. Farman, BDS, PhD, MBA, DSc, Diplomate ABOMR
>
> Prof. Radiology & Imaging Science
> Univ. Louisville School of Dentistry: SUHD
> 501 South Preston Street,
> Louisville, Kentucky 40292, USA
>
> Tel: +1(502) 852.1241
> Fax: +1(502)852.1626
>
>
>>>> "Benn, Douglas K." <DouglasBenn at creighton.edu> 5/5/2009 8:22 AM >>>
> I went to an Oral Medicine CE course last year and the speaker said the 
> problem with bisphosphonates is they have a long half life of 10 years. It 
> would be interesting to know how stopping treatment 9 months before 
> surgical treatment fits into this scenario.
>
> Douglas
>
> Dr Douglas K Benn, BDS, M.Phil., Ph.D., Dipl. Dental Radiology (Royal 
> College of Radiologists, England).
> Professor
> Dept of General Dentistry
> Creighton University Dental School
> 2500 California Plaza
> Omaha
> Nebraska 68178
>
> Tel: (402)280 5025
> Fax: (402)280 5094
>
>
>
> -----Original Message-----
> From: oradlist-bounces at lists.ucla.edu on behalf of Dania Tamimi
> Sent: Tue 5/5/2009 5:28 AM
> To: oradlist at lists.ucla.edu
> Subject: Re: [Oradlist] mail survey
>
>
> Hello everyone,
>
>
>
> I am attending the ACOMS meeting (American College of OM Surgery). Just 
> yesterday, I sat through a talk on the guidelines of treatement for BIONJ. 
> The speaker recommended non-invasive procedures if possible. If an 
> invasive procedure is indicated, then a "drug holiday" of 9 months is 
> recommended prior to the treatment. A diagnostic test is before the drug 
> holiday and when the treatment is done to determine the levels of 
> something called CTX (C-terminal telopeptide). Apparently if this goes up, 
> then the healing is supposed to be more favorable. Here's a reference J 
> Oral Maxillofac Surg. 2007 Dec;65(12):2397-410.
>
>
>
> He also said that the worst offender amongst bisphosponates is Fosamax, 
> because it delivers a higher dose in  shorter period of time (75 whatever 
> the unit is a week, in contrast to intravenous, which gives double the 
> quantity but is only given once a month)
>
>
>
> The speaker seemed to be the go-to guy for BIONJ. His name is Robert Marx 
> (Marx RE). If you search for his articles on medline, you will find a good 
> amount of info on the subject.
>
>
>
> Date: Mon, 4 May 2009 15:43:18 -0400
> From: lurie at nso.uchc.edu
> To: oradlist at lists.ucla.edu
> Subject: Re: [Oradlist] mail survey
>
> Dear ORAD Listers,
>
> I have never, in my aging memory, sent a hostile email to the list. 
> However, yet again we have a case of ONJ being subtly mis-represented. 
> Following is the concluding paragraph from the report:
>
>
> "Chronic refractory osteomyelitis of the jaws (CROJ) is a potential side 
> effect of bisphosphonates, in particular with zoledronic acid. Both 
> mandible and maxilla can be affected. The treatment of CROJ should be, if 
> possible, discontinuation of the zoledronic acid therapy, in combination 
> with a surgical debridement of the osteonecrotic lesion, a strict 
> antibiotic protocol and a meticulous oral hygiene by the patient."
>
> This patient had intravenous bisphosphonate therapy as part of treatment 
> for breast cancer.  The vast majority of ONJ which is related to 
> bisphosphonate therapy is thus.  The cases of ONJ which are related to 
> oral bisphosphonate therapy for osteopenia and osteoporosis is miniscule 
> compared to the millions and millions - perhaps tens of millions - of 
> patient receiving such therapy.  Physicians, dentists and patients are 
> being excessively, and in my opinion unnecessarily, sent into a 
> quasi-panic mode by such representations.  Review of the literature 
> concerning ONJ from oral bisphosphonate therapy is thin at best.  We need 
> controlled, prospective studies before potentially condemming a superb 
> treatment of bone demineralizing diseases which cause such tremendous 
> morbidity and mortality worldwide.
>
> We should all be exceptionally clear when we report any ONJ cases such as 
> this that we clearly state, throughout the report, that the patient 
> received intravenous bisphosphonate treatment.
>
>
> On 5/4/09 3:25 PM, "Johan Aps" <johan.aps at ugent.be> wrote:
>
>> Dear OradFriends,
>>
>> I hereby repost my mail of 8 April 09 again with the PDF file on
>> bisphosphonates.
>> I hope this may be of any help to anyone who is keen on this
>> interesting issue.
>>
>> Kind regards from Belgium (it is 9.25 PM now)
>>
>> Johan
>
> _________________________________________________________________
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