TY - JOUR
TI - Periodontal disease preceding osteonecrosis of the jaw (ONJ) in cancer patients receiving antiresorptives alone or combined with targeted therapies: Report of 5 cases and literature review
AU - Nicolatou-Galitis, O.
AU - Razis, E.
AU - Galiti, D.
AU - Galitis, E.
AU - Labropoulos, S.
AU - Tsimpidakis, A.
AU - Sgouros, J.
AU - Karampeazis, A.
AU - Migliorati, C.
JO - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
PY - 2015
VL - 120
TODO - 6
SP - 699-706
PB - Mosby Year Book Inc
SN - 2212-4403
TODO - 10.1016/j.oooo.2015.08.007
TODO - antineoplastic agent;  bisphosphonic acid derivative;  bone density conservation agent;  ibandronic acid;  imidazole derivative;  zoledronic acid, aged;  Bisphosphonate-Associated Osteonecrosis of the Jaw;  case report;  fatality;  female;  human;  male;  middle aged;  Neoplasms;  panoramic radiography;  Periodontal Diseases;  retrospective study;  tooth extraction, Aged;  Antineoplastic Agents;  Bisphosphonate-Associated Osteonecrosis of the Jaw;  Bone Density Conservation Agents;  Diphosphonates;  Fatal Outcome;  Female;  Humans;  Imidazoles;  Male;  Middle Aged;  Neoplasms;  Periodontal Diseases;  Radiography, Panoramic;  Retrospective Studies;  Tooth Extraction
TODO - Objective We present clinical and radiologic data of periodontal tissue involvement preceding the appearance of osteonecrosis of the jaw (ONJ) in 5 patients with solid tumors, who received antiresorptives alone or in combination with targeted therapies. Study Design Five patients with osteonecrosis before dental extraction were studied. Results Periodontal involvement was evidenced by pain, bleeding, fistula, purulence, swelling, periodontal pocket, and tooth mobility. Combined endoperiodontal lesions were considered in 1 patient. Duration of symptoms before ONJ diagnosis lasted 8 to 24 weeks. Routine therapy was performed in 2 of 5 patients. Widening of the periodontal ligament was observed in 4 patients, and dense alveolar bone was seen in 1 patient. Local complications of ONJ required dental extractions in 4 of 5 patients. Spontaneous tooth exfoliation was observed in 1 patient. Alveolar bone biopsies, after the extraction in 2 patients, confirmed osteonecrosis. Osteonecrosis healed in 2 patients - 1 after the dental extraction and 1 after 3 dental extractions and surgical debridement. Postextraction socket healed in 1 patient, and the area with exposed bone remained asymptomatic. Osteonecrosis progressed in 2 patients. Conclusions Clinical and radiologic signs of periodontal tissue involvement, before dental extraction in patients treated with antiresorptives alone or in combination with targeted therapy, may represent developing osteonecrosis. © 2015 Elsevier Inc.
ER -