title: A 5-year retrospective longitudinal study on the incidence and the risk factors of osteonecrosis of the jaws in patients treated with zoledronic acid for bone metastases from solid tumors.
abstract: BACKGROUND
  The aim of this study was to evaluate the incidence and the risk factors of osteonecrosis of the jaw (ONJ) in a group of patients treated with zoledronic acid (ZA) for bone metastases from solid tumors and enrolled in a preventive dental program.
  
  
  METHODS
  This 5-year retrospective longitudinal study included all consecutive oncological patients who underwent at least one infusion with ZA between 2004 and 2011 for bone metastases due to solid neoplasms.
  
  
  RESULTS
  Of the 156 patients enrolled in the study, 17 developed ONJ (10.89%). At the multivariate analysis, severe periodontal disease (P=0.025), tooth extraction (P<0.0001) and starting the preventive dental program after the beginning of ZA therapy (P=0.02) were the only factors which showed a significant association with the occurrence of ONJ.
  
  
  CONCLUSIONS
  This study demonstrated the importance of beginning dental prevention before zoledronic acid exposure in reducing ONJ occurrence, especially in the long term. The results of this research show that control of periodontal disease and an increase in the time between tooth extraction and the first ZA administration are recommended in order to reduce the risk of ONJ development.
authors.affiliation: Unit of Oral Pathology, Medicine and Laser Surgery Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T), University of Parma Viale Gramsci 14, 43100 Parma, Italy, maddalena.manfredi@unipr.it.
authors.forename: M
authors.initials: M
authors.lastname: Manfredi
authors.forename: G
authors.initials: G
authors.lastname: Mergoni
authors.forename: M
authors.initials: M
authors.lastname: Goldoni
authors.forename: S
authors.initials: S
authors.lastname: Salvagni
authors.forename: E
authors.initials: E
authors.lastname: Merigo
authors.forename: M
authors.initials: M
authors.lastname: Meleti
authors.forename: P
authors.initials: P
authors.lastname: Vescovi
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000453:epidemiology* / Q000209:etiology*; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid