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"Pamiętaj o tym, że twoje swobodne i wolne od zajęć chwile obciążone są największymi zadaniami i odpowiedzialnością." - św. Augustyn
  dr hab. n. med. Artur Jurczyszyn

  Specjalista chorób wewnętrznych, hematolog
CZYTELNIA

Publikacje

State of Oral Mucosa as an Additional Symptom in the Course of Primary Amyloidosis and Multiple Myeloma Disease



Hindawi Publishing Corporation
Case Reports in Medicine
Volume 2014, Article ID 293063, 5 pages

strona www

1. Introduction
For the last twenty years, an increasing number of patients have been referred to specialised dental offices with alarming symptoms and pathological changes in their mouth [1–5]. The latter concerns not only the marginal tissue (tooth root, periodontium, bone of alveolar process, and gingivalmargin) and/or apical periodontium (root apex and gingiva proper) but also lips, cheek mucosa, hard palate, soft palate, palatine arches, tongue, and sublingual region of oral cavity.

Multiple myeloma (MM) is one of the most common haematological tumours. In Poland, approximately 1500 new cases of MM are diagnosed every year. MM develops in 4 to 5 per 100 000 people per year and frequency increases with age. The median age of diagnosis is between 60 and 70 years of age. It is a malignant tumour classified byWHO as a non-Hodgkin lymphoma derived from B lymphocytes. It consists in the growth of a plasma cells clone synthesizing monoclonal immunoglobulins or their fragments that infiltrate the bone marrow thus destroying the bone structure, also in facial parts of the skull and in periodontium. This prevents the creation of appropriate blood morphotic elements. Patients very often suffer from progression of periodontal disease (PD) which, in the beginning, leads to gum bleeding and later to pathological loosening of teeth, atrophy of bone support and of surrounding periodontal tissues, and eventually tooth loss. These changes are accompanied by other pathological symptoms in the mucosa and especially in the tongue [6–9].

The medicines from the group of bisphosphonates are used in the treatment of MM. They can cause osteonecrosis of the jaw (ONJ) [10, 11]. In 2003 the first case of ONJ was described in a patient who was treated with bisphosphonates—BRON (bisphosphonate-related to osteonecrosis). The American Association of Oral Maxillofacial Surgeons (AAOMS) defined three pathognomonic criteria on which BRON relies:

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