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Volume 9
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10.3390/dj9020011
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Article

The Importance of Alliance between Hematologists and Dentists: A Retrospective Study on the Development of Bisphosphonates Osteonecrosis of the Jaws (Bronj) in Multiple Myeloma Patients

by
Christian Bacci
1,*,
Alessia Cerrato
1,
Virginia Dotto
1,
Renato Zambello
2,
Gregorio Barilà
2,
Albana Liço
2,
Gianpietro Semenzato
2,
Edoardo Stellini
1 and
Gastone Zanette
1
1
Clinical Dentistry Department of Neurosciences Via Giustiniani 1, University of Padova, 35128 Padova, Italy
2
Department of Medicine, Hematology and Clinical Immunology Section, University of Padova, 35128 Padova, Italy
*
Author to whom correspondence should be addressed.
Dent. J. 2021, 9(2), 11; https://doi.org/10.3390/dj9020011
Submission received: 18 November 2020 / Revised: 24 December 2020 / Accepted: 14 January 2021 / Published: 20 January 2021
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Abstract

(1) Background: Multiple myeloma is a rare cancer that primarily affects the bone marrow. Osteoclasts are responsible for increased bone resorption and, therefore, bone destruction. Bisphosphonates are a class of drugs that can slow down bone resorption by reducing the number and action of osteoclasts. Intravenous injections of bisphosphonates (generally Zoledronic Acid) are administered to patients affected by Multiple Myeloma, but BRONJ is described as a serious side effect. This 5-year retrospective study aims to evaluate the efficacy of appropriate dental treatment protocols prior to initiating bisphosphonate therapy to prevent the development of BRONJ. (2) Methods: A total of 99 patients with symptomatic multiple myeloma were involved in this study (41–90 years, mean age 65 years, standard deviation 5 years). The data relating to the visits were tracked using a specific server and consulting the clinical reports. The AAOMS (American Association of Oral and Maxillofacial Surgeons) position was applied for both diagnosis and treatment. A total of 79 patients were examined before the administration of bisphosphonates (group A) and 20 after (group B). (3) Results: The entire sample required dental treatment: 23.2% underwent restorative therapy, 8% endodontic treatments, 44.4% tooth extractions. Periodontal disease was present in 41.4% of the patients. No osteonecrosis was observed in the first group, whereas BRONJ was found in five patients of the second one (25%) and two patients (10%) showed osteosclerotic areas under investigation [OR 0.026 (CI 0.0027 to 0.2454)]. (4) Conclusions: In the literature, there are no precise data about the prevalence of BRONJ. Despite the limitation of the present study, we point out that dental treatment before the treatment with intravenous bisphosphonates can help in reducing the incidence of BRONJ and good dental status is necessary for BRONJ prevention.
Keywords: MRONJ; BRONJ; ONJ; osteonecrosis; myeloma; bisphosphonates MRONJ; BRONJ; ONJ; osteonecrosis; myeloma; bisphosphonates

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MDPI and ACS Style

Bacci, C.; Cerrato, A.; Dotto, V.; Zambello, R.; Barilà, G.; Liço, A.; Semenzato, G.; Stellini, E.; Zanette, G. The Importance of Alliance between Hematologists and Dentists: A Retrospective Study on the Development of Bisphosphonates Osteonecrosis of the Jaws (Bronj) in Multiple Myeloma Patients. Dent. J. 2021, 9, 11. https://doi.org/10.3390/dj9020011

AMA Style

Bacci C, Cerrato A, Dotto V, Zambello R, Barilà G, Liço A, Semenzato G, Stellini E, Zanette G. The Importance of Alliance between Hematologists and Dentists: A Retrospective Study on the Development of Bisphosphonates Osteonecrosis of the Jaws (Bronj) in Multiple Myeloma Patients. Dentistry Journal. 2021; 9(2):11. https://doi.org/10.3390/dj9020011

Chicago/Turabian Style

Bacci, Christian, Alessia Cerrato, Virginia Dotto, Renato Zambello, Gregorio Barilà, Albana Liço, Gianpietro Semenzato, Edoardo Stellini, and Gastone Zanette. 2021. "The Importance of Alliance between Hematologists and Dentists: A Retrospective Study on the Development of Bisphosphonates Osteonecrosis of the Jaws (Bronj) in Multiple Myeloma Patients" Dentistry Journal 9, no. 2: 11. https://doi.org/10.3390/dj9020011

APA Style

Bacci, C., Cerrato, A., Dotto, V., Zambello, R., Barilà, G., Liço, A., Semenzato, G., Stellini, E., & Zanette, G. (2021). The Importance of Alliance between Hematologists and Dentists: A Retrospective Study on the Development of Bisphosphonates Osteonecrosis of the Jaws (Bronj) in Multiple Myeloma Patients. Dentistry Journal, 9(2), 11. https://doi.org/10.3390/dj9020011

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