Yi-Fang Huang1,2,3, Kuan-Chou Lin2,4, Shih-Ping Liu5,6,7, Chung-Ta Chang2,8,9, Chih-Hsin Muo10, Po-Jen Chang2, Chun-Hao Tsai11,12, Ching-Zong Wu13,14,15. 1. Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan. 2. School of Dentistry, College of Oral Medicine, Taipei Medical University, No. 250, Wu-Hsing St., Xinyi Dist, Taipei, 11031, Taiwan. 3. Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. 4. Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, 11696, Taiwan. 5. Graduate Institute of Basic Medical Science, China Medical University, Taichung, 40402, Taiwan. 6. Center for Neuropsychiatry, China Medical University Hospital, Taichung, 40402, Taiwan. 7. Department of Social Work, Asia University, Taichung, 41354, Taiwan. 8. Department of Emergency Medicine, Far Eastern Memorial Hospital, Taipei, 22056, Taiwan. 9. Graduate Institute of Medicine, Yuan Ze University, Taoyuan, 32003, Taiwan. 10. Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan. 11. Graduate Institute of Clinical Medicine, China Medical University, Taichung, 40402, Taiwan. 12. Department of Orthopedics, China Medical University Hospital, Taichung, 40402, Taiwan. 13. School of Dentistry, College of Oral Medicine, Taipei Medical University, No. 250, Wu-Hsing St., Xinyi Dist, Taipei, 11031, Taiwan. chinaowu@tmu.edu.tw. 14. Department of Dentistry, Taipei Medical University Hospital, Taipei, 11031, Taiwan. chinaowu@tmu.edu.tw. 15. Department of Dentistry, Lotung Poh-Ai Hospital, Yilan, 26546, Taiwan. chinaowu@tmu.edu.tw.
Abstract
OBJECTIVES: To determine the relation between the severity of periodontitis and osteonecrosis of the jaw (ONJ) occurrence among different cancer locations and estimate the effect of dental care on ONJ prevention in cancer patients. MATERIALS AND METHODS: This population-based cross-sectional study was conducted through the Longitudinal Health Insurance Database, Taiwan. Patients with malignancies were collected and subdivided into groups according to their different cancer locations, the severity of periodontitis, and dental care. Multivariable logistic regression analysis was performed to assess the associations between ONJ and ONJ-related factors. RESULTS: A total of 8,234 ONJ patients and 32,912 control patients were investigated. Lip, oral cavity, and pharynx malignancies had the highest ONJ risk among all cancer locations (OR from 3.07 to 9.56, P < 0.01). There is a linear relationship between different severities of periodontitis and ONJ. Patients with radiotherapy and severe periodontitis had the highest ONJ risk (adjusted OR, 9.56; 95% CI, 5.34-17.1). Patients with good dental care had a lower ONJ risk. CONCLUSIONS: The periodontal condition and cancer location showed a significant impact on the risk of developing ONJ after adjusting for bisphosphonate use. Good dental care could decrease the risk of ONJ in cancer patients. The severity of periodontitis might be a target to predict the potency of ONJ. CLINICAL RELEVANCE: Dentists must be vigilant about the increased risk of ONJ in cancer patients with periodontitis, especially in the head and neck cancer population. Good dental care is advised for cancer patients with severe periodontitis.
OBJECTIVES: To determine the relation between the severity of periodontitis and osteonecrosis of the jaw (ONJ) occurrence among different cancer locations and estimate the effect of dental care on ONJ prevention in cancer patients. MATERIALS AND METHODS: This population-based cross-sectional study was conducted through the Longitudinal Health Insurance Database, Taiwan. Patients with malignancies were collected and subdivided into groups according to their different cancer locations, the severity of periodontitis, and dental care. Multivariable logistic regression analysis was performed to assess the associations between ONJ and ONJ-related factors. RESULTS: A total of 8,234 ONJ patients and 32,912 control patients were investigated. Lip, oral cavity, and pharynx malignancies had the highest ONJ risk among all cancer locations (OR from 3.07 to 9.56, P < 0.01). There is a linear relationship between different severities of periodontitis and ONJ. Patients with radiotherapy and severe periodontitis had the highest ONJ risk (adjusted OR, 9.56; 95% CI, 5.34-17.1). Patients with good dental care had a lower ONJ risk. CONCLUSIONS: The periodontal condition and cancer location showed a significant impact on the risk of developing ONJ after adjusting for bisphosphonate use. Good dental care could decrease the risk of ONJ in cancer patients. The severity of periodontitis might be a target to predict the potency of ONJ. CLINICAL RELEVANCE: Dentists must be vigilant about the increased risk of ONJ in cancer patients with periodontitis, especially in the head and neck cancer population. Good dental care is advised for cancer patients with severe periodontitis.
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