nach oben

Erschienen in:

14.10.2020 | Original Article

Does inflammatory dental disease affect the development of medication-related osteonecrosis of the jaw in patients using high-dose bone-modifying agents?

verfasst von: Nobuhiro Ueda, Chie Nakashima, Kumiko Aoki, Hiroko Shimotsuji, Kazuhiko Nakaue, Hajime Yoshioka, Satoshi Kurokawa, Yuichiro Imai, Tadaaki Kirita

Erschienen in: Clinical Oral Investigations | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

High-dose bone–modifying agents (BMAs), such as bisphosphonates and denosumab, are essential for the treatment of cancer patients with bone metastases. The incidence of medication-related osteonecrosis of the jaw (MRONJ) is increasing. Inflammatory dental diseases could lead to MRONJ, and hence, they should be managed appropriately. Tooth extractions are commonly advised to prevent dental inflammation; however, the accurate indications for tooth extractions before starting BMA therapy have not been established. Hence, we assessed teeth with inflammatory dental diseases to identify indicators for prophylactic extraction before starting BMA therapy.

Materials and methods

We included 745 teeth with inflammatory dental diseases of 212 cancer patients on high-dose BMA therapy. We assessed the relationship between inflammatory dental disease and risk of MRONJ development. Multivariate Cox regression analysis was used for statistical analysis. The cumulative occurrence rate of MRONJ was calculated using the Kaplan–Meier method.

Results

MRONJ occurred in 43 of 745 teeth. Teeth characteristics significantly correlated with MRONJ occurrence were mandible (p = 0.009), molar region (p = 0.005), radiopaque changes in bone surrounding the root on orthopantograms obtained at patients’ first visits (p < 0.001), and tooth extractions after starting BMA therapy (p < 0.001).

Conclusions

Radiopaque changes in bone surrounding the root are an important radiographic finding that indicates the need for prophylactic tooth extractions before starting BMA therapy.

Clinical relevance

Our results suggest that the prophylactic extraction of teeth with radiopaque changes in bone surrounding the root before starting BMA therapy could prevent the onset of MRONJ.

Nur mit Berechtigung zugänglich

Berenson JR, Rajdev L, Broder M (2006) Treatment strategies for skeletal complications of cancer. Cancer Biol Ther 5:1074–1077. https://doi.org/10.4161/cbt.5.9.3305CrossRefPubMed

Fizazi K, Carducci M, Smith M, Damião R, Brown J, Karsh L, Milecki P, Shore N, Rader M, Wang H, Jiang Q (2011) Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: a randomised, double-blind study. Lancet 377:813–822. https://doi.org/10.1016/S0140-6736(10)62344-6CrossRefPubMedPubMedCentral

Marx RE (2003) Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 61:1115–1117. https://doi.org/10.1016/s0278-2391(03)00720-1CrossRefPubMed

Ruggiero S, Gralow J, Marx RE, Hoff AO, Schubert MM, Huryn JM, Toth B, Damato K, Valero V (2006) Practical guidelines for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in patients with cancer. J Oncol Pract 2:7–14. https://doi.org/10.1200/JOP.2006.2.1.7CrossRefPubMedPubMedCentral

Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, Taguchi A, Toyosawa S, Nagata T, Urade M (2010) Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research, Japan Osteoporosis Society, Japanese Society of Periodontology, Japanese Society for Oral and Maxillofacial Radiology and Japanese Society of Oral and Maxillofacial Surgeons. J Bone Miner Metab 28:365–383. https://doi.org/10.1007/s00774-010-0162-7CrossRefPubMed

Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O’Ryan F (2014) American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw—2014 update. J Oral Maxillofac Surg 72:1938–1956. https://doi.org/10.1016/j.joms.2014.04.031CrossRefPubMed

Yarom N, Shapiro CL, Peterson DE, Van Poznak CH, Bohlke K, Ruggiero SL, Migliorati CA, Khan A, Morrison A, Anderson H, Murphy BA, Alston-Johnson D, Mendes RA, Beadle BM, Jensen SB, Saunders DP (2019) Medication-related osteonecrosis of the jaw: MASCC/ISOO/ASCO Clinical Practice Guideline. J Clin Oncol 37:2270–2290. https://doi.org/10.1200/JCO.19.01186CrossRefPubMed

Abu-Id MH, Warnke PH, Gottschalk J, Springer I, Wiltfang J, Acil Y, Russo PA, Kreusch TJ (2008) “Bis-phossy jaws”—High and low risk factors for bisphosphonate-induced osteonecrosis of the jaw. Craniomaxillofac Surg 36:95–103. https://doi.org/10.1016/j.jcms.2007.06.008CrossRef

Kyrgidis A, Vahtsevanos K, Koloutsos G, Andreadis C, Boukovinas I, Teleioudis Z, Patrikidou A, Triaridis S (2008) Bisphosphonate-related osteonecrosis of the jaws: a case-control study of risk factors in breast cancer patients. J Clin Oncol 26:4634–4638. https://doi.org/10.1200/JCO.2008.16.2768CrossRefPubMed

10.

Barasch A, Cunha-Cruz J, Curro FA, Hujoel P, Sung AH, Vena D, Voinea-Griffin AE, Beadnell S, Craig RG, DeRouen T, Desaranayake A, Gilbert A, Gilbert GH, Goldberg K, Hauley R, Hashimoto M, Holmes J, Latzke B, Leroux B, Lindblad A, Richman J, Safford M, Ship J, Thompson VP, Williams OD, CONDOR Collaborative Group, Wanrong Y (2013) Risk factors for osteonecrosis of the jaws: a case-control study from the CONDOR Dental PBRN. Tex Dent J 130:299–307. https://doi.org/10.1177/0022034510397196CrossRefPubMed

11.

Otto S, Tröltzsch M, Jambrovic V, Panya S, Probst F, Ristow O, Ehrenfeld M, Pautke C (2015) Tooth extraction in patients receiving oral or intravenous bisphosphonate administration: a trigger for BRONJ development? J Craniomaxillofac Surg 43:847–854. https://doi.org/10.1016/j.jcms.2015.03.039CrossRefPubMed

12.

Avila G, Galindo-Moreno P, Soehren S, Misch CE, Morelli T, Wang HL (2009) A novel decision-making process for tooth retention or extraction. J Periodontol 80:476–591. https://doi.org/10.1902/jop.2009.080454CrossRefPubMed

13.

Lee J, Kang S, Jung HI, Kim S, Karabucak B, Kim E (2020) Dentists' clinical decision-making about teeth with apical periodontitis using a variable-controlled survey model in South Korea. BMC Oral Health 20:23. https://doi.org/10.1186/s12903-020-1014-zCrossRefPubMedPubMedCentral

14.

Soutome S, Hayashida S, Funahara M, Sakamoto Y, Kojima Y, Yanamoto S, Umeda M (2018) Factors affecting development of medication-related osteonecrosis of the jaw in cancer patients receiving high-dose bisphosphonate or denosumab therapy: is tooth extraction a risk factor? PLoS One 13:e0201343. https://doi.org/10.1371/journal.pone.0201343CrossRefPubMedPubMedCentral

15.

Yamazaki T, Yamori M, Ishizaki T, Asai K, Goto K, Takahashi K, Nakayama T, Bessho K (2012) Increased incidence of osteonecrosis of the jaw after tooth extraction in patients treated with bisphosphonates: a cohort study. Int J Oral Maxillofac Surg 41:1397–1403. https://doi.org/10.1016/j.ijom.2012.06.020CrossRefPubMed

16.

Saad F, Brown JE, Van Poznak C, Ibrahim T, Stemmer SM, Stopeck AT, Diel IJ, Takahashi S, Shore N, Henry DH, Barrios CH, Facon T, Senecal F, Fizazi K, Zhou L, Daniels A, Carrière P, Dansey R (2012) Incidence, risk factors, and outcomes of osteonecrosis of the jaw: integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases. Ann Oncol 23:1341–1347. https://doi.org/10.1093/annonc/mdr435CrossRefPubMed

17.

Tsao C, Darby I, Ebeling PR, Walsh K, O’Brien-Simpson N, Reynolds E, Borromeo G (2013) Oral health risk factors for bisphosphonate-associated jaw osteonecrosis. J Oral Maxillofac Surg 71:1360–1366. https://doi.org/10.1016/j.joms.2013.02.016CrossRefPubMed

18.

Fedele S, Porter SR, D’Aiuto F, Aljohani S, Vescovi P, Manfredi M, Arduino PG, Broccoletti R, Musciotto A, Di Fede O, Lazarovici TS, Campisi G, Yarom N (2010) Nonexposed variant of bisphosphonate-associated osteonecrosis of the jaw: a case series. Am J Med 123:1060–1064. https://doi.org/10.1016/j.amjmed.2010.04.033CrossRefPubMed

19.

Allen MR, Burr DB (2008) Mandible matrix necrosis in beagle dogs after 3 years of daily bisphosphonate treatment. J Oral Maxillofac Surg 66:987–994. https://doi.org/10.1016/j.joms.2008.01.038CrossRefPubMedPubMedCentral

20.

Huja SS, Fernandez SA, Hill KJ, Li Y (2006) Remodeling dynamics in the alveolar process in skeletally mature dogs. Anat Rec A Discov Mol Cell Evol Biol 288:1243–1249. https://doi.org/10.1002/ar.a.20396CrossRefPubMedPubMedCentral

21.

Tow DE, Garcia DA, Jansons D, Sullivan TM, Niederman R (1978) Bone scan in dental diseases. J Nucl Med 19:845–847PubMed

22.

Lyons KP, Jensen JL (1979) Dental lesions causing abnormalities on skeletal scintigraphy. Clin Nucl Med 4:509–512CrossRefPubMed

23.

Strittmatter EJ, Keller DL, LaBounty GL, Lewis DM, Graham GD (1989) The relationship between radionuclide bone scans and dental examinations. Oral Surg Oral Med Oral Pathol 68:576–581. https://doi.org/10.1016/0030-4220(89)90243-0CrossRefPubMed

24.

Ferreira RI, de Almeida SM, Boscolo FN, Santos AO, Camargo EE (2002) Bone scintigraphy as an adjunct for the diagnosis of oral diseases. J Dent Educ 66:1381–1387CrossRefPubMed

25.

Arias JA, Pardo C, Olmos A, Cuadrado ML, Ruibal A (2004) Dental diseases and radionuclide imaging of the jaws. Nucl Med Commun 25:305–310. https://doi.org/10.1097/00006231-200403000-00015CrossRefPubMed

26.

Garetto LP, Chen J, Parr JA, Roberts WE (1995) Remodeling dynamics of bone supporting rigidly fixed titanium implants: a histomorphometric comparison in four species including humans. Implant Dent 4:235–243. https://doi.org/10.1097/00008505-199500440-00002CrossRefPubMed

Titel: Does inflammatory dental disease affect the development of medication-related osteonecrosis of the jaw in patients using high-dose bone-modifying agents?
verfasst von: Nobuhiro Ueda
Chie Nakashima
Kumiko Aoki
Hiroko Shimotsuji
Kazuhiko Nakaue
Hajime Yoshioka
Satoshi Kurokawa
Yuichiro Imai
Tadaaki Kirita
Publikationsdatum: 14.10.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 5/2021
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03632-7

Neu im Fachgebiet Zahnmedizin

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Parodontalbehandlung verbessert Prognose bei Katheterablation

19.04.2024 Vorhofflimmern Nachrichten

Werden Personen mit Vorhofflimmern in der Blanking-Periode nach einer Katheterablation gegen eine bestehende Parodontitis behandelt, verbessert dies die Erfolgsaussichten. Dafür sprechen die Resultate einer prospektiven Untersuchung.

Invasive Zahnbehandlung: Wann eine Antibiotikaprophylaxe vor infektiöser Endokarditis schützt

11.04.2024 Endokarditis Nachrichten

Bei welchen Personen eine Antibiotikaprophylaxe zur Prävention einer infektiösen Endokarditis nach invasiven zahnärztlichen Eingriffen sinnvoll ist, wird diskutiert. Neue Daten stehen im Einklang mit den europäischen Leitlinienempfehlungen.

Zell-Organisatoren unter Druck: Mechanismen des embryonalen Zahnwachstums aufgedeckt

08.04.2024 Zahnmedizin Nachrichten

Der Aufbau von Geweben und Organen während der Embryonalentwicklung wird von den Zellen bemerkenswert choreografiert. Für diesen Prozess braucht es spezielle sogenannte „Organisatoren“. In einer aktuellen Veröffentlichung im Fachjournal Nature Cell Biology berichten Forschende durch welchen Vorgang diese Organisatoren im Gewebe entstehen und wie sie dann die Bildung von Zähnen orchestrieren.

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Does inflammatory dental disease affect the development of medication-related osteonecrosis of the jaw in patients using high-dose bone-modifying agents?