title: Oral avascular bone necrosis associated with chemotherapy and biphosphonate therapy.
abstract: BACKGROUND
  Oral avascular bone necrosis is an important adverse effect of chemotherapy and biphosphate therapy.
  
  
  OBJECTIVE
  To report our experience in oral avascular bone necrosis in cancer patients assigned to undergo chemotherapy.
  
  
  METHODS
  Fourteen patients presenting oral avascular bone necrosis were selected from the clinical files of five Stomatological Clinics in Brazil. Clinical data as well as treatment and prognosis information were obtained from all 14 patients.
  
  
  RESULTS
  Twelve patients (86%) were submitted to biphosphonate therapy. The most important symptom was pain, present in all cases, and the mandible was the most common involved site. Most patients (79%) had their conditions managed by antibiotic therapy and surgical debridation; however complete response was achieved in only three cases (21%).
  
  
  CONCLUSIONS
  Avascular bone necrosis is a serious oral side-effect of cancer chemotherapy, particularly in patients using biphosphonates, and antibiotic therapy and surgical debridation were not able to promote complete response in most cases.
authors.affiliation: Department of Stomatology, Estácio de Sá University, Rio de Janeiro, RJ, Brazil. ramoafop@yahoo.com
authors.forename: F R
authors.initials: FR
authors.lastname: Pires
authors.forename: Amma
authors.initials: A
authors.lastname: Miranda
authors.forename: E S
authors.initials: ES
authors.lastname: Cardoso
authors.forename: A S
authors.initials: AS
authors.lastname: Cardoso
authors.forename: E R
authors.initials: ER
authors.lastname: Fregnani
authors.forename: C M
authors.initials: CM
authors.lastname: Pereira
authors.forename: M E P
authors.initials: ME
authors.lastname: Correa
authors.forename: J P
authors.initials: JP
authors.lastname: Almeida
authors.forename: F de A
authors.initials: Fde A
authors.lastname: Alves
authors.forename: M A
authors.initials: MA
authors.lastname: Lopes
authors.forename: O P
authors.initials: OP
authors.lastname: de Almeida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000139:chemically induced*; D010020:Osteonecrosis / Q000139:chemically induced*
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates