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Biomedical subjects

Michael A Siegel

Publications and source records attributed to Michael A Siegel.

8 recordsLinked to original sources
PubMed2006

Bisphosphonate-associated osteonecrosis: a long-term complication of bisphosphonate treatment.

We present current knowledge of bisphosphonate-associated osteonecrosis, a new oral complication in oncology. It was first described in 2003, and hundreds of cases have been reported worldwide. The disorder affects patients with cancer on bisphosphonate treatment for multiple myeloma or bone metastasis from breast, prostate, or lung cancer. Bisphosphonate-associated osteonecrosis is characterised by the unexpected appearance of necrotic bone in the oral cavity. Osteonecrosis can develop spontaneously or after an invasive surgical procedure such as dental extraction. Patients might have severe pain or be asymptomatic. Symptoms can mimic routine dental problems such as decay or periodontal disease. Intravenous use of pamidronate and zoledronic acid is associated with most cases. Other risk factors include duration of bisphosphonate treatment (ie, 36 months and longer), old age in patients with multiple myeloma, and a history of recent dental extraction. We also discuss pathobiology, clinical features, management, and future directions for the disorder.

Antineoplastic Agents↗
PubMed2005

An overview of oral frena and their association with multiple syndromic and nonsyndromic conditions.

The development of abnormal oral frena is an important diagnostic feature of several syndromic states. Five such syndromes are reviewed which include Ehlers-Danlos syndrome, infantile hypertrophic pyloric stenosis, holoprosencephaly, Ellis-van Creveld syndrome, and oral-facial-digital syndrome. Each syndrome exhibits relatively specific frena abnormalities, ranging from multiple, hyperplastic, hypoplastic, or absent. 1-8 In addition to abnormal oral frena observed in syndromic conditions, anomalous frena are encountered without other associated phenotypic features of genetic or chromosomal states. 9 This paper is a review of the above stated frena deformities and their management.

Abnormalities, Multiple↗
PubMed2005

Managing the care of patients with bisphosphonate-associated osteonecrosis: an American Academy of Oral Medicine position paper.

BACKGROUND: This position paper addresses the prevention of bisphosphonate-associated osteonecrosis (BON) and the management of care of patients with cancer and/or osteoporosis who are receiving bisphosphonates and who have BON or are at risk of developing it. METHODS: The authors reviewed the literature available on this newly described oral complication. Information of interest included bisphosphonates, the medications associated with this oral complication; the patient population at risk of developing BON and the diseases being treated with this class of medications; the clinical presentation of the oral lesions; guidelines for managing the care of patients who develop BON; the prevention of this complication based on current knowledge; and recommendations for routine dental treatment of patients receiving bisphosphonates. RESULTS: There is strong evidence that bisphosphonate therapy is the common link in patients with BON. The pathobiological mechanism leading to BON may have to do with the inhibition of bone remodeling and decreased intraosseous blood flow caused by bisphosphonates. People at risk include patients with multiple myeloma and patients with cancer metastatic to bone who are receiving intravenous bisphosphonates, as well as patients taking bisphosphonates for osteoporosis. The risk of developing complications appears to increase with time of use of the medication. There are no guidelines based on evidence, and the clinical management of the oral complication is based on expert opinion. CONCLUSION: Prevention of BON is the best approach to management of this complication. Existing protocols to manage the care of patients who will receive radiation therapy or chemotherapy may be used until specific guidelines for BON are developed.

Antineoplastic Agents↗
PubMed2004

Head and neck diagnostic challenge.

An interesting and unusual clinical case is presented to challenge the dentist's diagnostic acumen. Diagnostic and management consideration will be discussed, and a list of suggested readings is provided.

Adult↗
PubMed2003

Advances in the diagnosis and management of human viral hepatitis.

This article presents a comprehensive review of viral hepatitis types A through G and TTV. The information that is provided includes the definition, causes, signs and symptoms, diagnosis, pathogenesis, and acute and chronic forms of hepatitis. The modes of transmission, risk groups, morbidity and mortality, epidemiology, and treatment modalities are also presented. The primary objective for this extensive review is to provide dental health care workers with the most current information on the subject, which will allow them to identify the patients who will potentially have complications as the result of invasive dental treatment. By using this information, dental health care workers can be assured that they are practicing "state-of-the-art dentistry" while ensuring the health of their patients, staff, and families.

Dental Care for Chronically Ill↗
PubMed2002

Diagnosis and management of recurrent herpes simplex infections.

BACKGROUND: Dentists are frequently asked by patients to diagnose and treat recurrent herpetic infections, which are painful and disfiguring. The author explores the diagnosis and treatment of these commonly encountered viral conditions. OVERVIEW: Herpetic infections represent a reactivation of the herpes simplex virus, which is highly infectious to patients, their families, dentists and staff members. The diagnosis of these conditions usually is based on case-specific historical findings, the characteristic clinical appearance and the location of the lesions. CONCLUSIONS: Dentists often treat patients with a history of recurrent herpetic infections. Currently used topical antiviral agents, when used in a timely manner, are well-absorbed and quite effective in decreasing the severity and duration of herpetic episodes. CLINICAL IMPLICATIONS: Until the herpetic lesions are completely healed, the dental team and patient should use management strategies to prevent spread of the virus, ensure adequate nutrition and maintain appropriate oral hygiene practices.

Administration, Topical↗