[Bisphosphonate-related osteonecrosis of the jaw]. / Bisfosfonaatgerelateerde osteonecrose van de kaak.

Osteonecrosis of the jaw in association with long-term use of bisphosphonates (BRONJ) is a relatively rare but serious side effect that is difficult to treat. The incidence of BRONJ in patients treated for osteoporosis is low at 0.1%. The incidence in cancer patients treated with high doses of intravenous bisphosphonates is higher, ranging between 3% and 10%. Risk factors for BRONJ are invasive treatments such as tooth extractions, root canal procedures and the placement of dental implants, as well as trauma caused by pressure from poorly fitting dental prostheses. High-risk patients should be examined by a dentist or an oral surgeon and, if necessary, undergo dental treatment prior to treatment with bisphosphonates. All patients taking bisphosphonates should maintain good oral hygiene, receive regular dental examinations and see a dentist if any oral symptoms develop. Physicians who prescribe medication as well as the patient's dentist and oral surgeon should be aware of the use of bisphosphonates and BRONJ as a possible adverse reaction. This requires cooperation and the exchange of information between a patient's health care providers.

The effect of metoclopramide on the Ganzfeld electroretinogram.

Antecedent light flashes enhance the amplitude of the electroretinogram (ERG) oscillatory potentials, but do not modify other ERG responses nor dark-adaptation sensory thresholds. Metoclopramide infusion (i.v.) has a generally attenuating effect on the ERG, which is more evident under conditions of dark- than light-adaptation. Metoclopramide decreases the peak amplitude of the rod b-wave and the dark-adapted cone b-wave in a similar manner; it also significantly increases the implicit time of the rod b-wave, but not of the dark-adapted cone b-wave. In addition metoclopramide reverses the enhancement of the oscillatory potentials by the antecedent light flashes.