title: Antibiotic prophylaxis before dental procedures may reduce the incidence of osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates.
abstract: Osteonecrosis of the jaw (ONJ) can be a severe complication of patients with multiple myeloma (MM) treated with bisphosphonates. Dental procedures are a major risk factor for ONJ occurrence. We retrospectively analysed the data of 178 patients with MM to evaluate if antibiotic prophylaxis before dental procedures may prevent ONJ. A correlation between dental procedures, antibiotic prophylaxis, incidence of ONJ and relevant clinical features was performed. Overall nine out of 178 patients developed ONJ (5 year crude cumulative incidence: 7.7%). Only one case of ONJ was not correlated with dental procedures. Seventy-five patients received at least one dental procedure and 43 received antibiotic prophylaxis. Eight cases of ONJ were observed, all in the group of patients without antibiotic prophylaxis. The only variable significantly associated with ONJ was antibiotic prophylaxis (p = 0.012), which had a protective effect. Thus, we speculated that antibiotic prophylaxis may prevent ONJ occurrence after dental procedures.
authors.affiliation: Department of Hematology, Allogeneic Bone Marrow Transplantation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. vittorio.montefusco@istitutotumori.mi.it
authors.forename: Vittorio
authors.initials: V
authors.lastname: Montefusco
authors.forename: Francesca
authors.initials: F
authors.lastname: Gay
authors.forename: Francesco
authors.initials: F
authors.lastname: Spina
authors.forename: Rosalba
authors.initials: R
authors.lastname: Miceli
authors.forename: Massimo
authors.initials: M
authors.lastname: Maniezzo
authors.forename: Maria
authors.initials: M
authors.lastname: Teresa Ambrosini
authors.forename: Lucia
authors.initials: L
authors.lastname: Farina
authors.forename: Sheila
authors.initials: S
authors.lastname: Piva
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000379:methods; D003729:Dental Care / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D019552:Infection Control, Dental / Q000379:methods*; D007571:Jaw Diseases / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy; D010020:Osteonecrosis / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies
chemical_list: D004164:Diphosphonates