Legg-Calvé-Perthes disease (LCPD) is known as a self-limiting pediatric orthopedic pathology that affects the hip due to ischemia with consequent aseptic avascular necrosis of the femoral head. This is a systematic literature review carried out in the databases indexed in the Medical Literature Analysis and Retrieval System Online (MEDLINE) in accordance with the precepts established by the PRISMA methodology (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The aim was to compare the effectiveness of treatment for Legg-Calvé-Perthes disease in relation to its staging: the limits of conservative treatment. Conservative treatment was used in four studies, and most patients under the age of 6.5 had Stulberg I and II results. Older patients, between eight and ten years old, had a relatively better classification when they underwent surgical treatment. In this context, the data collected did not show significant variations; however, it was possible to observe that conservative treatment was more effective in this population, while surgical treatment is better recommended at older ages.

UNASSIGNED: Photodynamic therapy (PDT) is a minimally invasive treatment modality that has been used clinically for early stage and inoperable cancers. Successful use of this atraumatic therapy in osteoradionecrosis (ORN) and osteonecrosis of the jaws (ONJ) has been documented in the literature. The aim of this review was to systematically evaluate the role of photodynamic therapy in ORN and ONJ.
UNASSIGNED: Two independent reviewers conducted an elaborate search in PubMed, Google Scholar and Cochrane\'s CENTRAL database for studies published on PDT as stand-alone or adjuvant therapy in ORN/ONJ until June 2022. The present study was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Demographic data, type and stage of necrosis of the jaws, site, PDT protocol, time to heal and follow-up were evaluated. Eighteen articles were included totally based on the inclusion and exclusion criteria for final analysis.
UNASSIGNED: A total of 94 patients were included in the present review out of which 36 were males and 58 were females. Five studies reported the use of PDT as an adjuvant therapy in ORN. Thirteen studies reported successful outcomes with PDT in ONJ. Complete epithelialization was achieved with PDT ± other adjuvants in 86/94 (91.48%) patients. The time taken for regression of the lesion ranged between 4 days and 12 months with PDT in the present study.
UNASSIGNED: The reviewed studies demonstrate the effectiveness of PDT, as an adjuvant therapy, in managing various stages of ORN and ONJ.

UNASSIGNED: Humeral head osteonecrosis in the pediatric patients most often occurs in patients with underlying hemoglobinopathies, exposure to chronic corticosteroids, or after trauma. The purpose of this study was to perform a systematic review evaluating the prevalence, clinical characteristics, and management of humeral head osteonecrosis in the pediatric population.
UNASSIGNED: PubMed, Ovid MEDLINE, and Scopus were screened with the terms \"osteonecrosis,\" \"avascular necrosis,\" \"pediatric,\" and \"proximal humerus\" on January 10, 2024. A total of 218 studies were screened, and 74 studies were evaluated for eligibility. Studies that reported on the prevalence and/or management of pediatric humeral head osteonecrosis were included. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines.
UNASSIGNED: Twelve studies met inclusion criteria: four retrospective case series, three prospective case series, one retrospective cohort study, one retrospective case-control study, and three case reports. A majority of the studies (67%) discussed chemotherapy-induced osteonecrosis of the humeral head. A total of 77 patients (106 shoulders) with humeral head osteonecrosis were identified. The overall prevalence of osteonecrosis of the humeral head across eight studies examining at-risk populations (underlying hemoglobinopathies or undergoing chemotherapy) was 2%. Intra-articular steroid injections, physical therapy, and activity modification are effective conservative management strategies. Additionally, core decompression and hemiarthroplasty are surgical treatment options.
UNASSIGNED: The prevalence of osteonecrosis of the humeral head is low even among at-risk populations with associated medical conditions. A variety of conservative and surgical treatment options have been described, but no comparative evaluations of these modalities has been conducted.
UNASSIGNED: IV.

BACKGROUND: We present a case of a 29-year-old male patient without immunodeficiency who suffered from rapid osteonecrosis and tooth exfoliation resulting from herpes zoster (HZ) infection in the left maxillary branch of the trigeminal nerve. Various complications associated with shingles infections have been reported, cases of osteonecrosis and tooth exfoliation due to HZ infection among young people without immunodeficiency are rare. In this case, we focus on the particular manifestation of HZ infection.
METHODS: The patient presented with clusters of erythema and papules, along with non-hemorrhagic blisters on the left face and the loss of the left upper incisor. All lesions were localized to the left side of the face without exceeding the midline. After receiving antibacterial and antiviral treatment, successful control over the infection was achieved; however, he experienced the loss of all upper teeth on the left side except for the first and second upper left molars.
CONCLUSIONS: This case highlights that rapid osteonecrosis and tooth exfoliation may occur among young individuals without immunodeficiency after HZ infection. HZ infection of the face should be taken very seriously to obtain prompt treatment to prevent the rare complications of bone necrosis and tooth loss as much as possible.

UNASSIGNED: Despite being rare, we have presented a case of osteonecrosis of acetabulum that followed total hip arthroplasty. It\'s crucial to act appropriately, as it emulates periprosthetic joint infection. The key point is that the osteonecrosis of acetabulum may necessitate revision and can be classified as aseptic loosening.
UNASSIGNED: Osteonecrosis of the femoral head is well known and managed with total hip arthroplasty (THA). Acetabulum osteonecrosis can be classified as a cause of painful THA and the cemented acetabular component is a feasible option. However, it seems that the osteonecrosis of acetabulum is sparsely alluded in literature. In this case report sustaining of the right hip pain following THA of 35-year-old woman is discussed.

Osteonecrosis of the jaw (ONJ) can occur through various mechanisms including radiation, medication, and viral infections such as herpes zoster. Although herpes zoster is a varicella-zoster virus infection that can affect the trigeminal nerve, it rarely causes oral complications. The author reports a rare case of herpes zoster-related ONJ, followed by a review of the relevant literature pertaining to herpes zoster-related oral complications, including ONJ. A 73-year-old woman presented with a scarred skin lesion on her left midface with an exposed alveolar bone of the left maxilla. Based on her medical records, she received a diagnosis and treatment for herpes zoster six months prior and experienced a few teeth loss in the left maxilla following a fall preceding the onset of herpes zoster. Sequestrectomy of the left maxilla was performed and ONJ was diagnosed. The operative site recovered favorably. Although unusual, several cases of localized extensive ONJ in herpes zoster-infected patients have been reported. This case illustrates the possibility of a rare occurrence of unilateral widespread osteonecrosis of the jaw (ONJ) even in the maxilla associated with herpes zoster. The exact mechanism has not been elucidated; nevertheless, surgeons should consider the possibility of oral and dental complications, including ONJ, related to a history of herpes zoster.

This study aimed to report the collective clinical characteristics of oral side effects associated with imatinib therapy according to age, sex, and clinical condition. A bibliographic review was performed using the PubMed, Web of Science, Scopus, Cochrane Library, and Embase databases. Forty-five cases of oral side effects due to imatinib therapy were identified in the literature. With the addition of five new cases seen at the authors\' institution, a total of 50 cases were analysed. Of the five new cases, four with gastrointestinal stromal tumours developed oral lichenoid lesions (OLLs), and one with chronic myeloid leukaemia (CML) developed oral hyperpigmentation (OHP). Of the total 50 patients, 26 were male and 24 were female, and age ranged from 29 to 86 years. Most patients were ≥50 years old (80%); only three patients were jaw was the least common, with just five cases (10%). Among the patients with OHP, the predominant clinical condition was CML (22 cases, 91.7%). In conclusion, the possibility of oral side effects needs to be considered during the examination of patients receiving imatinib therapy.

OBJECTIVE: To map the current scientific landscape regarding the association/causality of medication-related osteonecrosis of the jaw (MRONJ) after tooth extraction under bisphosphonate (BF) therapy to identify knowledge gaps and guide future research.
METHODS: This review used the PCC strategy (P = Patient; C = Concept; C = Context).
METHODS: The MEDLINE/PubMed, Scopus, Web of Science/Clarivate Analytics, and gray literature databases were used.
METHODS: Searches were conducted by two independent reviewers until April 2024. Studies involving prior BF use and tooth extraction in humans or animals were included. Among the 176 studies, 73 (41.4 %) were in animals, and 103 (58.5 %) were in humans. Brazil led in animal studies (n = 14; 19.1 %), while Italy led in human studies (n = 14; 13.6 %). Zoledronic acid was the most cited BF (79.4 % in animals; 34.9 % in humans), with intravenous administration being most frequent (38.3 % in animals; 35.9 % in humans). The mandible was the main extraction site (n = 36 in animals; n = 41 in humans). In 91.7 % of the animal studies, sequelae compatible with osteonecrosis signs and symptoms were observed, with bone necrosis being most common (n = 39; 53.4 %). In humans, 93.2 % of studies presented 239 sequelae, with bone necrosis (n = 53; 22.1 %) being the most cited. The main location of sequelae was the mandible (n = 36 in animals; n = 41 in humans).
CONCLUSIONS: Animal studies highlighted bone exposure, notably using murine models, with a significant Brazilian contribution. In human studies, bone necrosis was the main sequela of MRONJ, which has been reported by researchers in the Italy.
CONCLUSIONS: These findings underscore the importance of careful consideration and monitoring of patients who have a history of bisphosphonate use and who are undergoing tooth extraction, highlighting the potential risk of MRONJ.

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