Talk:Osteonecrosis of the jaw

Great Article

This is a great article, but is deficient in one aspect - osteoradionecrosis, which is still the most common form of osteonecrosis of the jaws. Also, no mention of hyperbaric oxygen therapy, which is used to treat this form of osteonecrosis (not bisphosphonate induced). I'll try and get something done.Dr-G - Illigetimi nil carborundum est. 00:53, 6 February 2007 (UTC)

Copyedit to article and observations for development

User:Dr. Imbeau well done on creating such a full and well cited article. I've had a brief copyedit over the article:

• Spaces: remove duplicate, spaces immediate after and before opening/closing brackets, spaces between reference links
• Repeated use of the same reference can be marked-up as a duplicate of the same link in the cite.php system (see WP:FOOTNOTES).
  • Essentially give each reference a name, so for the first occurrence of a citation: <ref name="xxx"> details </ref>
    The actual name need not be in double-quotes unless it contains a space, but most authors do so out of habit.
  • Then for subsequent occurrences either use the whole markup again, or as cite.php ignores all the details on subsequent identically named refs, just <ref name="xxx"/>
    The shortened version is obviously easier to remember and re-use later in the text, but it does require a fully defined first occurrence of the citation. Should a later edit/editor remove the first occurrence, then the subsequent duplicates will just show as a number and a link character (e.g. 24 ^) and all details of the citation are lost. Using the full form for each occurrence is cumbersome, but deletion of the first occurrence does not affect subsequent occurrences.
• If one can look up and find an article abstract in PubMed (search link is http://www.ncbi.nlm.nih.gov/entrez/query.fcgi). Then if one takes the abstract number into Dibberi's tool at http://diberri.dyndns.org/wikipedia/templates (remember to ensure set for PubMed ID option), it will generate the markup for the Template:cite journal giving a consistent format for citations (other citation templates include Template:cite web, Template:cite book,Template:cite news etc).

The article is very detailed and needs a more general tweak of style:

• Simpler introduction to the aetiology. Perhaps with the "simple" introduction under the main "Aetiology" heading and the greater detail under "Pathophysiology" sub-heading.
• Medical jargon terms are used without definition for the lay reader. It is not the place within this article of course to give full definitions of terms. Options are greater use of wikilinks, brief phrase definition e.g. "tissue death (necrosis)" or a general rephrasing (these 3 appraoches in turn to "trabeculae", "non-suppurative" and "In healthy bone these cells are constantly replaced by differentiation of bone marrow mesenchymal stem cells (MSC)").
• Wikipedia is not an undergraduate or post-graduate textbook. This article, in its current form, will not get close to being Wikipedia:Good articles status, let alone the target of Wikipedia:Featured articles.
• It is not so much that the points raised are excessively high-brow, just that it is difficult as a professional to write at the level of the lay-reader, rather than one's contemporaries - all medical/dental professionals encounter this in wikipedia, myself included :-)
• So what level should one write for - primary school? high-school? or an under-graduate ? My view is that it is wrong to target any specific group, but rather to be inclusive of them all. Hence there is a general approach of starting simply and slowly adding in levels of details. This helps define core principles before dwelling on fine points of uncertainty. It also means that the younger readers can get a grasp of a topic, even if details later in an article extend beyond their needs in reading about a topic. My personal viewpoint is that articles should stop at a level of a good thorough undergraduate (this is after all a general encyclopaedia).

So really great start to an article on a topic I knew little about. I will try reading it more deeply when I have a chance (vs very quickly and with view of copyedit & initial wikifying). It will need some adjustment of tone/writing style for the wider wikipedia non-specialist readership (perhaps greater division of those long paragraphs, or use of subheadings?). David Ruben ^Talk 13:58, 3 October 2006 (UTC)

GAC

I judged this article on the following 7 criteria:

1. Well-written: Pass
2. Factually accurate: Pass
3. Broad: Pass
4. Neutrally written: Pass
5. Stable: Pass
6. Well-referenced: Pass
7. Images: Pass

Congratulations, it passes! I had to think a long time before passing this article, because it's obviously written by a medical professional (the Dr. in your username is a bit of a tip-off), and the subject matter is such that it is incredibly hard for a lay reader to understand. In the end though, I decided to pass it, because every single medical term is wikilinked, the lead is absolutely brilliant in explaining what's going on to anyone, and frankly, you can't describe this subject without using a lot of medical terms. Like I said though, the lead explains anything a lay reader would want to know, and the article itself is great, not to mention incredibly well-referenced. I'd suggest pushing this article to FAC if you want/have time, but there will probably be a fight about the reading level. Once again, congratulations on a great article! --PresN 17:05, 26 October 2006 (UTC)

UK increased awareness - BMJ/BNF

Having followed the development of this article about a condition I had never previously heard of, two items worthy of mention that will (or at least should) increase awareness.

1. Latest edition of British National Formulary (September 2006, but only just now being distributed to all UK NHS doctors, surgeries and hospitals) adds in the leader section on biphosphonates a whole subsection paragraph on ONj. Its wording (re mostly with higher dose of iv therapy and to sort out potential sites of infection first) is almost identical to that of the paper by Woo this year.
2. Latest edition of the British Medical Journal has an article on ONj.
   • Landis B, Richter M, Dojcinovic I, Hugentobler M (2006). "Osteonecrosis of the jaw after treatment with bisphosphonates: is irreversible, so the focus must be on prevention". BMJ. 333 (7576): 982–3. PMID 17095762.{{cite journal}}: CS1 maint: multiple names: authors list (link)
   • The BMJ link to extract is here, from where the Rapid Responses can be read (and the whole article if one has a subscription). David Ruben ^Talk 23:59, 14 November 2006 (UTC)

writing for the average reader

This is an excellent article, and I hope it will become featured in the future... however my concern lies with the use of jargon, and the obvious writing from the specialist perspective... For example mentioning "the literature" in the first paragraph, aetiology (instead of causes), histopathology (microscopic changes might be better, with a link to pathology perhaps in the first sentence of the paragraph?), and so on. Just a hint.--Steven Fruitsmaak (Reply) 12:58, 6 December 2006 (UTC)

Systematic review

This systematic review of the 93 published cases doi:10.1016/j.amjmed.2008.01.047 shows that the majority of cases had undergone dental work and most of them were on other medications interfering with bone turnover. This ought to be cited. JFW | T@lk 11:04, 21 May 2008 (UTC)

Lay version

This "lay description was added on 1st December. The lead-in is meant to be the simple introduction, and then each section start simply and get into greater detail. I've removed it for now and post it below for further consideration (at the very least, article space edits are not signed)David Ruben ^Talk 14:56, 5 January 2009 (UTC)

LAY DESCRIPTION

Osteonecrosis of the jaw is a condition that results in death of segment of the jaw bone. More commonly it has been reported in cancer patients with extensive malignant disease who require high dose intravenous bisphosphonates to halt skeletal metastatsis (93% of cases). It has been most commonly reported in patiuets with multiple myeloma, breast and prostate cancer, although it has also been reported in other types of cancer. The incidence increases with the duration of bisphosphonate therapy and may be as high as 10-15% after 3 years of therapy. Lesions may be extensive and may require oral antibiotic care, in general aggressive surgical intervention is avoided. In rare cases have jaw bone grafts been necessary. Occasionally ONJ will be a chronic indolent condition leading to hospitalization and disability.

ONJ has also been described in oral bisphosphonate users (for osteoporosis or Paget’s disease) although at much lower rates (< 1:10,000). ONJ lesions in these patients also appear to be smaller and respond well to local care progressing to complete healing.

Predisposing factors:

cancer, use of chemotherapy or glucocorticoids, radiation therapy to the head and neck region, diabetes mellitus, smoking, periodontal disease

Precipitating factors:

dental trauma or dental extraction

Medradar (talk) 22:16, 24 August 2008 (UTC)

Beatrice J Edwards MD b e, Mrinal Gounder MD b d, June M McKoy MD a d, Ian Boyd MD f, Prof Mathew Farrugia MD g, Prof Cesar Migliorati DDS h, Prof Robert Marx DDS i, Prof Salvatore Ruggiero MD j, Prof Meletios Dimopoulos MD k, Prof Dennis W Raisch PhD l, Prof Seema Singhal MD b d, Ken Carson MD b d, Eniola Obadina MD b, Steve Trifilio RPh b d, Prof Dennis West PhD c, Prof Jayesh Mehta MD b d, Prof Charles L Bennett MD a b d (2008). "Pharmacovigilance and reporting oversight in US FDA fast-track process: bisphosphonates and osteonecrosis of the jaw". The Lancet Oncology (December). {{cite journal}}: Text "Pages 1166 - 1172" ignored (help); Text "Volume 9, Issue 12" ignored (help); Text "doi:10.1016/S1470-2045(08)70305-X" ignored (help)CS1 maint: multiple names: authors list (link)

Osteoradionecrosis

No mention is made of ORN or its treatment with HBOT. Here are a couple refs.

Pitak-Arnnop P, Sader R, Dhanuthai K; et al. (2008). "Management of osteoradionecrosis of the jaws: an analysis of evidence". Eur J Surg Oncol. 34 (10): 1123–34. doi:10.1016/j.ejso.2008.03.014. PMID 18455907. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

Gerlach NL, Barkhuysen R, Kaanders JH, Janssens GO, Sterk W, Merkx MA (2008). "The effect of hyperbaric oxygen therapy on quality of life in oral and oropharyngeal cancer patients treated with radiotherapy". Int J Oral Maxillofac Surg. 37 (3): 255–9. doi:10.1016/j.ijom.2007.11.013. PMID 18262761. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

--Doc James (talk · contribs · email) 04:25, 10 January 2009 (UTC)

GA

Do not believe this article meets GA as it is to narrow in scope. Does not cover radiation induced osteo necrosis and its treatment.--Doc James (talk · contribs · email) 00:37, 21 May 2009 (UTC)

Fossy/phossy jaw article

"Fossy jaw" redirects here, but there's a separate article on Phossy jaw. I'd fix this myself, but I frankly have no idea how to do so ... maybe I need a user account to do so 88.112.12.243 (talk) 09:30, 30 August 2009 (UTC)

More than a year later, still needs doing. I don't know how without messing up the history. DavidOaks (talk) 19:33, 23 September 2010 (UTC)

I decided to Be bold and changed it, nothing linked to the redirect (except maybe archived versions), so I guess it's ok. It is the obvious redirect for the term. DS Belgium (talk) 23:49, 4 October 2011 (UTC)

International conference

2011 paper: doi:10.1111/j.1749-6632.2010.05929.x JFW | T@lk 22:21, 26 November 2011 (UTC)