TY - JOUR
TI - Alveolar bone histological necrosis observed prior to extractions in patients, who received bone-targeting agents
AU - Nicolatou-Galitis, O.
AU - Papadopoulou, E.
AU - Vardas, E.
AU - Kouri, M.
AU - Galiti, D.
AU - Galitis, E.
AU - Alexiou, K.-E.
AU - Tsiklakis, K.
AU - Ardavanis, A.
AU - Razis, E.
AU - Athanasiadis, I.
AU - Droufakou, S.
AU - Psyrri, A.
AU - Karamouzis, M.V.
AU - Linardou, H.
AU - Daliani, D.
AU - Tzanninis, D.
AU - Sachanas, S.
AU - Laschos, K.
AU - Kyrtsonis, M.-C.
AU - Antoniou, F.
AU - Laskarakis, A.
AU - Giassas, S.
AU - Nikolaidi, A.
AU - Rigakos, G.
AU - Ntokou, A.
AU - Migliorati, C.A.
AU - Ripamonti, C.I.
JO - Journal of Oral Diseases
PY - 2020
VL - 26
TODO - 5
SP - 955-966
PB - Wiley-Blackwell Publishing Ltd
SN - 2314-6516
TODO - 10.1111/odi.13294
TODO - amoxicillin;  bevacizumab;  bortezomib;  cabazitaxel;  capecitabine;  clarithromycin;  clindamycin;  cyclophosphamide;  cytotoxic agent;  denosumab;  docetaxel;  erlotinib;  everolimus;  gefitinib;  lenalidomide;  metronidazole;  paclitaxel;  trastuzumab;  vinorelbine tartrate;  zoledronic acid;  bisphosphonic acid derivative;  bone density conservation agent, adult;  aged;  alveolar bone loss;  Article;  blood examination;  bone biopsy;  bone metastasis;  breast cancer;  cancer chemotherapy;  cancer patient;  chondrosarcoma;  clinical examination;  controlled study;  dental caries;  dental procedure;  drug substitution;  drug withdrawal;  female;  fistula;  histology;  human;  human cell;  human tissue;  jaw osteonecrosis;  jaw pain;  lung cancer;  major clinical study;  male;  melanoma;  molecularly targeted therapy;  multiple myeloma;  nonhodgkin lymphoma;  osteoporosis;  paresthesia;  periodontal disease;  priority journal;  prospective study;  prostate cancer;  radiodiagnosis;  suppuration;  swelling;  tooth extraction;  tooth fracture;  tooth infection;  tooth pain;  treatment failure;  wound healing;  X ray;  diagnostic imaging;  jaw osteonecrosis;  neoplasm, Bisphosphonate-Associated Osteonecrosis of the Jaw;  Bone Density Conservation Agents;  Diphosphonates;  Humans;  Neoplasms;  Tooth Extraction
TODO - Objective: We reported the alveolar bone histology prior to dental extractions in cancer patients, who received bone-targeting agents (BTA). Subjects and Methods: Fifty-four patients were included. Patients underwent extractions, and bone biopsies were taken. Results: Extractions were performed due to pain, swelling, purulence, fistula, and numbness, not responding to treatment, in 40 patients (group A); extractions due to asymptomatic, non-restorable teeth, were performed in 14 patients (group B). Complete alveolar jaw bone histological necrosis was observed in 28 of 40 (70%) patients of group A and none of group B (p <.001). The development of clinical osteonecrosis (MRON) was assessed in 44 patients; 10 patients, who were also treated with Low Level Laser Treatments-LLLT, were excluded from this analysis, as the alternative therapies were a confounding factor. Twelve patients, with alveolar bone histological necrosis prior to extraction, developed medication-related osteonecrosis of the jaw (MRONJ) compared with two patients with vital or mixed vital/non-vital bone (p <.0007). BTAs >1 year and concurrent targeted therapy were also significantly associated with MRONJ (p =.016 and p =.050). Conclusion: Pain, swelling, purulence, fistula, and numbness were significantly associated with complete bone histological necrosis prior to extractions and increased MRONJ development. Research is justified to explore whether histological necrosis represents an early stage of osteonecrosis. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved
ER -