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Cancer Patients at Risk of Jaw Necrosis After Treatment

Study finds extractions or dentures increase risk after bisphosphonate treatment

THURSDAY, Oct. 8 (HealthDay News) -- Cancer patients treated with bisphosphonates have a higher risk of developing osteonecrosis of the jaw (ONJ) if they have had dental extractions or dentures, according to a study published online Oct. 5 in the Journal of Clinical Oncology.

Konstantinos Vahtsevanos, M.D., from Theagenio Cancer Hospital in Thessaloniki, Greece, and colleagues examined the incidence and risk factors for ONJ in 1,621 cancer patients treated with 29,006 intravenous monthly doses of bisphosphonates (zoledronate, ibandronate, and pamidronate).

The researchers found that 8.5 percent of multiple myeloma patients, 3.1 percent of breast cancer patients, and 4.9 percent of prostate cancer patients developed ONJ. After adjusting for possible confounding factors, the risk of ONJ was much higher in patients with dentures (adjusted odds ratio, 2.02), those with a history of dental extraction (adjusted odds ratio, 32.97), those who had ever received zoledronate (adjusted odds ratio, 28.09), and with increasing zoledronate dose (adjusted odds ratio, 2.02).

"The present study validates dental extractions and use of dentures as risk factors for ONJ development," Vahtsevanos and colleagues conclude. "Before initiation of any bisphosphonates, and especially zoledronate, patients with cancer should have a comprehensive dental examination, preferably by an oral surgeon who is experienced in the prevention and treatment of ONJ."

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