Ourania Nicolatou-Galitis1, Evangelia Razis2, Dimitra Galiti3, Evangelos Galitis4, Stefanos Labropoulos2, Antonis Tsimpidakis2, Joseph Sgouros5, Athanasios Karampeazis6, Cesar Migliorati7. 1. Clinic of Hospital Dentistry, Dental School, University of Athens, Athens, Greece. Electronic address: Nicolatou.galitis@hotmail.com. 2. Third Medical Oncology Department, Hygeia Hospital, Athens, Greece. 3. Clinic of Hospital Dentistry, Dental School, University of Athens, Athens, Greece. 4. Clinic of Orofacial Pain, Dental School, University of Athens, Athens, Greece. 5. Third Department of Medical Oncology, Agioi Anargyroi Cancer Hospital, Nea Kifissia, Athens, Greece. 6. Medical Oncology Unit, NIMTS Veterans Hospital, Athens, Greece. 7. Department of Diagnostic Sciences and Oral Medicine, University of Tennessee Health Science Center College of Dentistry, Memphis, Tennessee, USA.
Abstract
OBJECTIVE: We present clinical and radiologic data of periodontal tissue involvement preceding the appearance of osteonecrosis of the jaw (ONJ) in 5 patients with solid tumors, who received antiresorptives alone or in combination with targeted therapies. STUDY DESIGN: Five patients with osteonecrosis before dental extraction were studied. RESULTS: Periodontal involvement was evidenced by pain, bleeding, fistula, purulence, swelling, periodontal pocket, and tooth mobility. Combined endoperiodontal lesions were considered in 1 patient. Duration of symptoms before ONJ diagnosis lasted 8 to 24 weeks. Routine therapy was performed in 2 of 5 patients. Widening of the periodontal ligament was observed in 4 patients, and dense alveolar bone was seen in 1 patient. Local complications of ONJ required dental extractions in 4 of 5 patients. Spontaneous tooth exfoliation was observed in 1 patient. Alveolar bone biopsies, after the extraction in 2 patients, confirmed osteonecrosis. Osteonecrosis healed in 2 patients--1 after the dental extraction and 1 after 3 dental extractions and surgical debridement. Postextraction socket healed in 1 patient, and the area with exposed bone remained asymptomatic. Osteonecrosis progressed in 2 patients. CONCLUSIONS: Clinical and radiologic signs of periodontal tissue involvement, before dental extraction in patients treated with antiresorptives alone or in combination with targeted therapy, may represent developing osteonecrosis.
OBJECTIVE: We present clinical and radiologic data of periodontal tissue involvement preceding the appearance of osteonecrosis of the jaw (ONJ) in 5 patients with solid tumors, who received antiresorptives alone or in combination with targeted therapies. STUDY DESIGN: Five patients with osteonecrosis before dental extraction were studied. RESULTS: Periodontal involvement was evidenced by pain, bleeding, fistula, purulence, swelling, periodontal pocket, and tooth mobility. Combined endoperiodontal lesions were considered in 1 patient. Duration of symptoms before ONJ diagnosis lasted 8 to 24 weeks. Routine therapy was performed in 2 of 5 patients. Widening of the periodontal ligament was observed in 4 patients, and dense alveolar bone was seen in 1 patient. Local complications of ONJ required dental extractions in 4 of 5 patients. Spontaneous tooth exfoliation was observed in 1 patient. Alveolar bone biopsies, after the extraction in 2 patients, confirmed osteonecrosis. Osteonecrosis healed in 2 patients--1 after the dental extraction and 1 after 3 dental extractions and surgical debridement. Postextraction socket healed in 1 patient, and the area with exposed bone remained asymptomatic. Osteonecrosis progressed in 2 patients. CONCLUSIONS: Clinical and radiologic signs of periodontal tissue involvement, before dental extraction in patients treated with antiresorptives alone or in combination with targeted therapy, may represent developing osteonecrosis.
Authors: Akishige Hokugo; Keiichi Kanayama; Shuting Sun; Kenzo Morinaga; Yujie Sun; QingQing Wu; Hodaka Sasaki; Hiroko Okawa; Courtney Evans; Frank H Ebetino; Mark W Lundy; Keivan Sadrerafi; Charles E McKenna; Ichiro Nishimura Journal: Bone Date: 2019-03-26 Impact factor: 4.398
Authors: Ourania Nicolatou-Galitis; Maria Kouri; Erofili Papadopoulou; Emmanouil Vardas; Dimitra Galiti; Joel B Epstein; Sharon Elad; Giuseppina Campisi; Nikolaos Tsoukalas; Kivanc Bektas-Kayhan; Winston Tan; Jean-Jacques Body; Cesar Migliorati; Rajesh V Lalla Journal: Support Care Cancer Date: 2018-10-23 Impact factor: 3.603
Authors: Erofili Papadopoulou; Ourania Nicolatou-Galitis; Ioannis Papassotiriou; Helena Linardou; Aikaterini Karagianni; Konstantinos Tsixlakis; Anthi Tarampikou; Kelly Michalakakou; Emmanouil Vardas; Dimitrios Bafaloukos Journal: Support Care Cancer Date: 2019-04-17 Impact factor: 3.603