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Dent. J. 2016, 4(4), 39; doi:10.3390/dj4040039

Delayed Diagnosis of Osteonecrosis of the Jaw (ONJ) Associated with Bevacizumab Therapy in Colorectal Cancer Patients: Report of Two Cases

1
Oral Surgery Department, Dental School, AOUP Città della Salute e della Scienza di Torino, Torino 10100, Italy
2
Maxillofacial Unit, Alessandria Hospital, Alessandria 15121, Italy
3
Radiology Department, Dental School, AOUP Città della Salute e della Scienza di Torino, Torino 10100, Italy
4
Oncology Unit, Molinette Hospital, AOUP Città della Salute e della Scienza di Torino, Torino 10100, Italy
5
Oncology Unit, Alessandria Hospital, Alessandria 15121, Italy
6
Centro di Documentazione Osteonecrosi, Alessandria 15121, Italy
*
Authors to whom correspondence should be addressed.
Academic Editor: Christian Walter
Received: 7 September 2016 / Revised: 22 October 2016 / Accepted: 24 October 2016 / Published: 29 October 2016
(This article belongs to the Special Issue New Cancer and Osteoporosis Therapies and Osteocrosis of the Jaws)
View Full-Text   |   Download PDF [5151 KB, uploaded 29 October 2016]   |  

Abstract

Medication-induced Osteonecrosis of the Jaw (MRONJ) has been reported not only after use of antiresorptive agents (bisphosphonates and denosumab), but also in cancer patients receiving antiangiogenic agents, alone or combined with antiresorptive drugs. We report two cases of MRONJ observed in colorectal cancer patients after bevacizumab therapy only. MRONJ was diagnosed, respectively, two and seven months after a tooth extraction; both the patients had received two courses of bevacizumab infusions (for a total of 29 and 10 administrations, respectively). We discuss if tooth extraction during or after antiangiogenic therapy could be a potential trigger of MRONJ, but also if an underlying bone disease not evident before oral surgery might be a possible cause. A careful drug history has to be registered by dental specialists in cancer patients before oral surgery and adequate imaging might be obtained to avoid a delayed diagnosis. View Full-Text
Keywords: colorectal cancer; bevacizumab; osteonecrosis of jaw; ONJ; MRONJ; bisphosphonate colorectal cancer; bevacizumab; osteonecrosis of jaw; ONJ; MRONJ; bisphosphonate
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Erovigni, F.; Gambino, A.; Cabras, M.; Fasciolo, A.; Bianchi, S.D.; Bellini, E.; Fusco, V. Delayed Diagnosis of Osteonecrosis of the Jaw (ONJ) Associated with Bevacizumab Therapy in Colorectal Cancer Patients: Report of Two Cases. Dent. J. 2016, 4, 39.

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