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Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures

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Haematology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy
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Oncology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy
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Centro Documentazione Osteonecrosi, Alessandria Hospital, 15121 Alessandria AL, Italy
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Maxillofacial Unit, Alessandria Hospital, 15121 Alessandria AL, Italy
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Authors to whom correspondence should be addressed.
Academic Editor: Christian Walter
Dent. J. 2016, 4(4), 45; https://doi.org/10.3390/dj4040045
Received: 31 August 2016 / Revised: 6 November 2016 / Accepted: 14 November 2016 / Published: 1 December 2016
(This article belongs to the Special Issue New Cancer and Osteoporosis Therapies and Osteocrosis of the Jaws)
Bisphosphonates (BPs) are administered to Multiple Myeloma (MM) patients with bone lytic lesion. Osteonecrosis of the Jaw (ONJ) is a complication reported since 2003 in patients treated with intravenous (IV) BPs such as zoledronic acid and pamidronate, with 6%–26.3% frequency in early literature series, before some preventive measures were recommended. We evaluated the occurrence of ONJ with and without dental preventive measures in MM patients treated with BPs in our centre between 1996 and 2015. Since 2005, MM patients (already under treatment or before treatment) underwent a baseline mouth assessment (dental visit, Rx orthopantomography, and eventual tooth avulsion or dental care if necessary) and were followed by a multidisciplinary team. We reviewed the charts of 119 MM patients receiving IV BPs, classified into 3 groups: (a) “historic group” (21 patients who had started BP treatment in years before the awareness of ONJ); (b) “screening group” (20 patients starting BPs without baseline evaluation); and (c) “prevention group” (78 patients starting therapy only after baseline preventive assessment and eventual dental care measures). ONJ was observed in 3/21 patients (14.2%) from group a, in 2/20 patients (10%) from group b, and in no patients from group c (0%). Notably, the median number of IV BP administrations decreased after 2005. Our data confirmed a meaningful reduction of ONJ risk in MM patients treated with BPs if preventive measures are applied. Both implementation of prevention measures and reduction of cumulative doses of IV BPs could have contributed to a decreased incidence of ONJ. View Full-Text
Keywords: Bisphosphonate; pamidronate; zoledronic acid; Multiple Myeloma; Osteonecrosis of the Jaws; BRONJ; MRONJ; prevention Bisphosphonate; pamidronate; zoledronic acid; Multiple Myeloma; Osteonecrosis of the Jaws; BRONJ; MRONJ; prevention
MDPI and ACS Style

Catania, G.; Monaco, F.; Limberti, G.; Alessio, M.; De Martino, I.; Barile, C.; Fasciolo, A.; Baraldi, A.; Ladetto, M.; Fusco, V. Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures. Dent. J. 2016, 4, 45. https://doi.org/10.3390/dj4040045

AMA Style

Catania G, Monaco F, Limberti G, Alessio M, De Martino I, Barile C, Fasciolo A, Baraldi A, Ladetto M, Fusco V. Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures. Dentistry Journal. 2016; 4(4):45. https://doi.org/10.3390/dj4040045

Chicago/Turabian Style

Catania, Gioacchino, Federico Monaco, Giulia Limberti, Manuela Alessio, Iolanda De Martino, Cecilia Barile, Antonella Fasciolo, Anna Baraldi, Marco Ladetto, and Vittorio Fusco. 2016. "Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures" Dentistry Journal 4, no. 4: 45. https://doi.org/10.3390/dj4040045

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