Author
John Fantasia
Bio: John Fantasia is an academic researcher from Hofstra University. The author has contributed to research in topics: Denosumab & Osteonecrosis of the jaw. The author has an hindex of 7, co-authored 10 publications receiving 1962 citations.
Papers
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TL;DR: The American Association of Oral and Maxillofacial Surgeons (AAOMS) developed guidelines for medication-related osteonecrosis of the jaw (MRONJ) in 2007 and 2009 as mentioned in this paper.
2,176 citations
TL;DR: A case of CCOC in the premolar area of the mandible in a 59-year-old woman demonstrated the presence of both EWSR1 and ATF1 gene rearrangements by fluorescence in situ hybridization.
Abstract: Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws that is more common in the mandible than maxilla and has a female preponderance with a peak incidence in the sixth decade. It is characterized by locally aggressive behavior and has the potential to metastasize. This tumor was recently reported to have a rearrangement of the Ewing sarcoma breakpoint region 1 gene (EWS RNA-binding protein 1, EWSR1) in 5 of 8 cases tested and of the activating transcription factor 1 gene (ATF1) in 1 case tested. We report a case of CCOC in the premolar area of the mandible in a 59-year-old woman. This case demonstrated the presence of both EWSR1 and ATF1 gene rearrangements by fluorescence in situ hybridization.
33 citations
TL;DR: Bisphosphonate therapy is indicated in the treatment of pts.
Abstract: 20526 Background: Bisphosphonate (BP) therapy is indicated in the treatment of pts. with symptomatic bony disease secondary to myeloma, solid tumors and in the treatment of osteoporosis. We have pr...
27 citations
TL;DR: A review of established and newer medications that have antiangiogenic properties and their role in the development of osteonecrosis of the jaws highlights the role of inhibitors of angiogenesis.
22 citations
TL;DR: A case of a laryngeal myxoma presenting clinically as a left vocal cord polyp in a 77 year old male, and review the literature related to this rare entity are reported.
Abstract: Myxomas are a rare benign neoplasm of uncertain mesenchymal cell origin, typically involving the heart. Laryngeal myxomas are uncommon, and are usually misdiagnosed as laryngeal polyp. To the best of our knowledge, there are only nine reported cases in the English literature. We report a case of a laryngeal myxoma presenting clinically as a left vocal cord polyp in a 77 year old male, and review the literature related to this rare entity.
12 citations
Cited by
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TL;DR: The American Association of Oral and Maxillofacial Surgeons (AAOMS) developed guidelines for medication-related osteonecrosis of the jaw (MRONJ) in 2007 and 2009 as mentioned in this paper.
2,176 citations
TL;DR: This update contains revisions to the diagnosis and staging and management strategies and highlights the status of basic science research.
1,727 citations
McMaster University1, Dalhousie University2, University of Calgary3, Charité4, Kaiser Permanente5, University of Auckland6, Matsumoto Dental University7, University of California, Los Angeles8, University of Florence9, University of Alberta10, University of Sheffield11, University of Toronto12, McGill University13, Jordan Hospital14, University of Southampton15, University of Oxford16, University of Alabama at Birmingham17, Medical University of Graz18, Aarhus University19, University of Victoria20, University of British Columbia21, University of Oulu22, International Osteoporosis Foundation23, King Saud University24, Laval University25, University of Cambridge26
TL;DR: In those patients at high risk for the development of ONJ, including cancer patients receiving high‐dose BP or Dmab therapy, consideration should be given to withholding antiresorptive therapy following extensive oral surgery until the surgical site heals with mature mucosal coverage.
Abstract: This work provides a systematic review of the literature from January 2003 to April 2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of the jaw (ONJ), and offers recommendations for its management based on multidisciplinary international consensus. ONJ is associated with oncology-dose parenteral antiresorptive therapy of bisphosphonates (BP) and denosumab (Dmab). The incidence of ONJ is greatest in the oncology patient population (1% to 15%), where high doses of these medications are used at frequent intervals. In the osteoporosis patient population, the incidence of ONJ is estimated at 0.001% to 0.01%, marginally higher than the incidence in the general population (<0.001%). New insights into the pathophysiology of ONJ include antiresorptive effects of BPs and Dmab, effects of BPs on gamma delta T-cells and on monocyte and macrophage function, as well as the role of local bacterial infection, inflammation, and necrosis. Advances in imaging include the use of cone beam computerized tomography assessing cortical and cancellous architecture with lower radiation exposure, magnetic resonance imaging, bone scanning, and positron emission tomography, although plain films often suffice. Other risk factors for ONJ include glucocorticoid use, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, ill-fitting dentures, as well as other drugs, including antiangiogenic agents. Prevention strategies for ONJ include elimination or stabilization of oral disease prior to initiation of antiresorptive agents, as well as maintenance of good oral hygiene. In those patients at high risk for the development of ONJ, including cancer patients receiving high-dose BP or Dmab therapy, consideration should be given to withholding antiresorptive therapy following extensive oral surgery until the surgical site heals with mature mucosal coverage. Management of ONJ is based on the stage of the disease, size of the lesions, and the presence of contributing drug therapy and comorbidity. Conservative therapy includes topical antibiotic oral rinses and systemic antibiotic therapy. Localized surgical debridement is indicated in advanced nonresponsive disease and has been successful. Early data have suggested enhanced osseous wound healing with teriparatide in those without contraindications for its use. Experimental therapy includes bone marrow stem cell intralesional transplantation, low-level laser therapy, local platelet-derived growth factor application, hyperbaric oxygen, and tissue grafting.
832 citations
Loyola University Chicago1, Cornell University2, University of Wisconsin-Madison3, University of Cincinnati Academic Health Center4, Harvard University5, Memorial Sloan Kettering Cancer Center6, University of California, San Francisco7, American Association of Clinical Endocrinologists8, University of Vermont Medical Center9, University of New Mexico10, Icahn School of Medicine at Mount Sinai11, Australian Catholic University12, Emory University13
TL;DR: A large number of the patients in this study had atypical femur fracture and the results confirmed the need for further investigation into the mechanisms leading to and effects of these fractures.
768 citations
University of Michigan1, Amgen2, University of Florence3, Laval University4, University of Lyon5, University of California, San Francisco6, University of Graz7, University of British Columbia8, University of Bern9, University of Liège10, Paris Descartes University11, Columbia University12, Leiden University Medical Center13
TL;DR: The yearly exposure-adjusted participant incidence of adverse events for all individuals receiving denosumab decreased from 165·3 to 95·9 per 100 participant-years over the course of 10 years, and serious adverse event rates were generally stable over time.
590 citations