1. Osteonecrosis of the jaw in oncology patients treated with bisphosphonates: prospective experience of a dental oncology referral center
- Author
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Erofili Papadopoulou, Marie-Christine Kyrtsonis, Panagiotis Repousis, Triantafyllia Sarri, Polyxeni Boziari, Ourania Nicolatou-Galitis, Aikaterini Karayianni, Vassilios Barbounis, and Cesar A. Migliorati
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pamidronate ,Zoledronic Acid ,Oral hygiene ,Group B ,Fluorides ,Neoplasms ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Prospective cohort study ,General Dentistry ,Aged ,Pain Measurement ,Aged, 80 and over ,Bone Density Conservation Agents ,Diphosphonates ,business.industry ,Incidence (epidemiology) ,Dental Prophylaxis ,Chlorhexidine ,Imidazoles ,Osteonecrosis ,Cancer ,Middle Aged ,Oral Hygiene ,medicine.disease ,Cariostatic Agents ,Anti-Bacterial Agents ,Surgery ,Treatment Outcome ,Zoledronic acid ,Otorhinolaryngology ,Injections, Intravenous ,Anti-Infective Agents, Local ,Female ,Oral Surgery ,Osteonecrosis of the jaw ,business ,Jaw Diseases ,Follow-Up Studies ,medicine.drug - Abstract
Objectives The objectives of this study were to define the incidence, pain, and healing in cancer patients treated with intravenous bisphosphonates. Study design The study included long-term follow-up of 99 bisphosphonate-using patients (group A) and conservative treatment of 67 patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ, group B) using 3 antibiotic schemes and oral hygiene. Results The frequency of zoledronic acid single-agent use was 85.9% and 69.8% in group A and B, respectively. Median follow-up was 13 months (group A) and 16 months (group B). Two patients in group A developed BRONJ (2%). Of those with BRONJ in group B who completed follow-up, healing occurred in 14.9% (7/47) and pain subsided in 80.9% (38/47). Healing was significant in patients who received pamidronate followed by zoledronic acid ( P = .023) and with BRONJ stages 0 and stage I ( P = .003). Conclusions This case series suggests that oral hygiene and conservative antibiotic therapy play a role in healing and pain alleviation in BRONJ. Oral hygiene and follow-up may decrease incidence of BRONJ.
- Published
- 2011