Prevention of osteonecrosis of the jaw in patients with bone metastases treated with bisphosphonates.
Bisphosphonates (BPs) are potent inhibitors of osteoclast-mediated bone resorption and are widely used in the treatment of bone metastases. Osteonecrosis of the jaw (ONJ) is the worst side-effect related to BP use. At our Center, we have implemented internal guidelines regarding the management of patients with bone metastases from solid tumors. Our analysis includes 200 patients affected by solid tumors with bone metastases who received zoledronic acid. They underwent a baseline mouth assessment to evaluate their dental conditions and to perform dental care; a dental follow-up was performed every six months. All patients received calcium and vitamin D daily. Dental examination and application of preventive measures led to a total reduction in ONJ in our patients treated with zoledronic acid. The keystone in management of ONJ is prevention, and the risk of developing ONJ during treatment with zoledronic acid is reduced by implementing preventive measures.
Experimental Medicine Department, Viale Regina Elena 324, University of Rome 'Sapienza', 00161 Roma, Italy. susanna.scarpa@uniroma1.it.
Francesca
F
DE Iuliis
Ludovica
L
Taglieri
Lucrezia
L
Amoroso
Stefania
S
Vendittozzi
Luciana
L
Blasi
Gerardo
G
Salerno
Rosina
R
Lanza
Susanna
S
Scarpa
D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000517:prevention & control*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D003945:Diagnosis, Oral / Q000379:methods*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
Bisphosphonates; bone metastasis; osteonecrosis of the jaw; zoledronic acid