title: Osteonecrosis of the jaw in oncology patients treated with bisphosphonates: prospective experience of a dental oncology referral center.
abstract: OBJECTIVE
  The objectives of this study were to define the incidence, pain, and healing in cancer patients treated with intravenous bisphosphonates.
  
  
  METHODS
  The study included long-term follow-up of 99 bisphosphonate-using patients (group A) and conservative treatment of 67 patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ, group B) using 3 antibiotic schemes and oral hygiene.
  
  
  RESULTS
  The frequency of zoledronic acid single-agent use was 85.9% and 69.8% in group A and B, respectively. Median follow-up was 13 months (group A) and 16 months (group B). Two patients in group A developed BRONJ (2%). Of those with BRONJ in group B who completed follow-up, healing occurred in 14.9% (7/47) and pain subsided in 80.9% (38/47). Healing was significant in patients who received pamidronate followed by zoledronic acid (P = .023) and with BRONJ stages 0 and stage I (P = .003).
  
  
  CONCLUSIONS
  This case series suggests that oral hygiene and conservative antibiotic therapy play a role in healing and pain alleviation in BRONJ. Oral hygiene and follow-up may decrease incidence of BRONJ.
authors.affiliation: Dental Oncology Unit, Clinic of Hospital Dentistry, School of Dentistry, University of Athens, Athens, Greece. nicolatou.galitis@lycos.com
authors.forename: Ourania
authors.initials: O
authors.lastname: Nicolatou-Galitis
authors.forename: Erofili
authors.initials: E
authors.lastname: Papadopoulou
authors.forename: Triantafyllia
authors.initials: T
authors.lastname: Sarri
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Boziari
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Karayianni
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Kyrtsonis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Repousis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Barbounis
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Migliorati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002327:Cariostatic Agents / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D003777:Dental Prophylaxis; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D007275:Injections, Intravenous; D007571:Jaw Diseases / Q000139:chemically induced* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D009910:Oral Hygiene; D010020:Osteonecrosis / Q000139:chemically induced* / Q000628:therapy; D010147:Pain Measurement; D000077268:Pamidronate; D011446:Prospective Studies; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D050071:Bone Density Conservation Agents; D002327:Cariostatic Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D000077268:Pamidronate; D005459:Fluorides; D002710:Chlorhexidine