Sakiko Soutome1, Mitsunobu Otsuru2, Maho Murata2, Kota Morishita2, Keisuke Omori2, Koki Suyama2, Saki Hayashida2, Masahiro Umeda2, Toshiyuki Saito3. 1. Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan. sakiko@nagasaki-u.ac.jp. 2. Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan. 3. Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
Abstract
PURPOSE: To retrospectively investigate whether apical lesion, alveolar bone loss, probing pocket depth, or local infectious symptoms were associated with the onset of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with high-dose antiresorptive agents who did not undergo tooth extraction. METHODS: The study included 92 patients receiving high-dose antiresorptive agent therapy who had teeth with apical lesion ≧ 3 mm, alveolar bone loss ≧ 1/2, probing pocket depth ≧ 4 mm, or local infection symptoms such as swelling, pain, and pus discharge, but did not undergo tooth extraction. Univariate and multivariate Cox regression analyses were performed to determine the relationship between each variable and MRONJ onset. RESULTS: MRONJ developed in 15 of 92 patients (35 of 404 teeth) from 74 to 1883 days (median, 383 days) after the first visit. Multiple Cox regression analysis revealed that a lower number of teeth, diabetes, increased leukocyte count, administration of antiresorptive agents for 180 days or more, local infection symptoms, apical lesion ≧ 3 mm, and probing pocket depth ≧ 4 mm were significantly correlated with the development of MRONJ. CONCLUSION: It is recommended that teeth with apical lesion ≧ 3 mm, probing pocket depth ≧ 4 mm, or local infection symptoms are extracted before or as early as possible after beginning of medication in cancer patients receiving high-dose antiresorptive agent therapy to prevent the development of MRONJ.
PURPOSE: To retrospectively investigate whether apical lesion, alveolar bone loss, probing pocket depth, or local infectious symptoms were associated with the onset of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with high-dose antiresorptive agents who did not undergo tooth extraction. METHODS: The study included 92 patients receiving high-dose antiresorptive agent therapy who had teeth with apical lesion ≧ 3 mm, alveolar bone loss ≧ 1/2, probing pocket depth ≧ 4 mm, or local infection symptoms such as swelling, pain, and pus discharge, but did not undergo tooth extraction. Univariate and multivariate Cox regression analyses were performed to determine the relationship between each variable and MRONJ onset. RESULTS: MRONJ developed in 15 of 92 patients (35 of 404 teeth) from 74 to 1883 days (median, 383 days) after the first visit. Multiple Cox regression analysis revealed that a lower number of teeth, diabetes, increased leukocyte count, administration of antiresorptive agents for 180 days or more, local infection symptoms, apical lesion ≧ 3 mm, and probing pocket depth ≧ 4 mm were significantly correlated with the development of MRONJ. CONCLUSION: It is recommended that teeth with apical lesion ≧ 3 mm, probing pocket depth ≧ 4 mm, or local infection symptoms are extracted before or as early as possible after beginning of medication in cancer patients receiving high-dose antiresorptive agent therapy to prevent the development of MRONJ.
Authors: Noam Yarom; Charles L Shapiro; Douglas E Peterson; Catherine H Van Poznak; Kari Bohlke; Salvatore L Ruggiero; Cesar A Migliorati; Aliya Khan; Archie Morrison; Holly Anderson; Barbara A Murphy; Devena Alston-Johnson; Rui Amaral Mendes; Beth Michelle Beadle; Siri Beier Jensen; Deborah P Saunders Journal: J Clin Oncol Date: 2019-07-22 Impact factor: 44.544
Authors: F Saad; J E Brown; C Van Poznak; T Ibrahim; S M Stemmer; A T Stopeck; I J Diel; S Takahashi; N Shore; D H Henry; C H Barrios; T Facon; F Senecal; K Fizazi; L Zhou; A Daniels; P Carrière; R Dansey Journal: Ann Oncol Date: 2011-10-10 Impact factor: 32.976
Authors: Aliya A Khan; Archie Morrison; David A Hanley; Dieter Felsenberg; Laurie K McCauley; Felice O'Ryan; Ian R Reid; Salvatore L Ruggiero; Akira Taguchi; Sotirios Tetradis; Nelson B Watts; Maria Luisa Brandi; Edmund Peters; Teresa Guise; Richard Eastell; Angela M Cheung; Suzanne N Morin; Basel Masri; Cyrus Cooper; Sarah L Morgan; Barbara Obermayer-Pietsch; Bente L Langdahl; Rana Al Dabagh; K Shawn Davison; David L Kendler; George K Sándor; Robert G Josse; Mohit Bhandari; Mohamed El Rabbany; Dominique D Pierroz; Riad Sulimani; Deborah P Saunders; Jacques P Brown; Juliet Compston Journal: J Bone Miner Res Date: 2015-01 Impact factor: 6.741