Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics · 2011
Osteonecrosis of the jaw in oncology patients treated with bisphosphonates: prospective experience of a dental oncology referral center.
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Nicolatou-Galitis Ourania, Papadopoulou Erofili, Sarri Triantafyllia, Boziari Polyxeni, Karayianni Aikaterini, Kyrtsonis Marie-Christine, Repousis Panagiotis, Barbounis Vassilios, Migliorati Cesar A
Аннотация
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.
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.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAnti-Bacterial AgentsAnti-Infective Agents, LocalBone Density Conservation AgentsCariostatic AgentsChlorhexidineDental ProphylaxisDiphosphonatesFemaleFluoridesFollow-Up StudiesHumansImidazolesInjections, IntravenousJaw DiseasesLongitudinal StudiesMaleMiddle AgedNeoplasmsOral HygieneOsteonecrosisPain MeasurementPamidronateProspective StudiesTreatment OutcomeZoledronic Acid