Machine learning to predict the occurrence of bisphosphonate-related osteonecrosis of the jaw associated with dental extraction: A preliminary report

Bone ◽  
2018 ◽  
Vol 116 ◽  
pp. 207-214 ◽  
Author(s):  
Dong Wook Kim ◽  
Hwiyoung Kim ◽  
Woong Nam ◽  
Hyung Jun Kim ◽  
In-Ho Cha
Keyword(s):  
Machine Learning ◽  
Preliminary Report ◽  
Osteonecrosis Of The Jaw ◽  
Dental Extraction

Osteonecrosis of the Jaw in Multiple Myeloma Patients: Clinical Features and Risk Factors

2006 ◽  
Vol 24 (6) ◽  
pp. 945-952 ◽  
Author(s):  
Ashraf Badros ◽  
Dianna Weikel ◽  
Andrew Salama ◽  
Olga Goloubeva ◽  
Abraham Schneider ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Bone Fractures ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Dental Extraction ◽  
Long Bone ◽  
Pathologic Features ◽  
Mixed Bacteria

Purpose To describe the clinical, radiologic, and pathologic features and risk factors for osteonecrosis of the jaw (ONJ) in multiple myeloma (MM) patients. Patients and Methods A retrospective review of 90 MM patients who had dental assessments, including 22 patients with ONJ. There were 62 men; the median age was 61 years in ONJ patients and 58 years among the rest. Prior MM therapy included thalidomide (n = 67) and stem-cell transplantation (n = 72). Bisphosphonate therapy included zoledronate (n = 34) or pamidronate (n = 17) and pamidronate followed by zoledronate (n = 33). Twenty-seven patients had recent dental extraction, including 12 patients in the ONJ group. Median time from MM diagnosis to ONJ was 8.4 years for the whole group. Results Patients usually presented with pain. ONJ occurred posterior to the cuspids (n = 20) mostly in the mandible. Debridement and sequestrectomy with primary closure were performed in 14 patients; of these, four patients had major infections and four patients had recurrent ONJ. Bone histology revealed necrosis and osteomyelitis. Microbiology showed actinomycetes (n = 7) and mixed bacteria (n = 9). More than a third of ONJ patients also suffered from long bone fractures (n = 4) and/or avascular necrosis of the hip (n = 4). The variables predictive of developing ONJ were dental extraction (P = .009), treatment with pamidronate/zoledronate (P = .009), longer follow-up time (P = .03), and older age at diagnosis of MM (P = .006). Conclusion ONJ appears to be time-dependent with higher risk after long-term use of bisphosphonates in older MM patients often after dental extractions. No satisfactory therapy is currently available. Trials addressing the benefits/risks of continuing bisphosphonate therapy are needed.

scholarly journals DENTAL EXTRACTION & DENOSUMAB. EVALUATION OF PIEZOELECTRIC SURGICAL PROTOCOL FOR MRONJ PREVENTION. PRELIMINARY REPORT.

Qeios ◽  
2021 ◽  
Author(s):  
FRANCESCO DELLA FERRERA ◽  
Luca Guaschino ◽  
Paolo Appendino ◽  
lorenzo basano ◽  
Alessandro Chiarelli
Keyword(s):  
Preliminary Report ◽  
Dental Extraction ◽  
Surgical Protocol

A preliminary report about treatment of bisphosphonate related osteonecrosis of the jaw with Er:YAG laser ablation

2009 ◽  
Vol 41 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Stefan Stübinger ◽  
Jan-Philipp Dissmann ◽  
Nicole Chambron Pinho ◽  
Belma Saldamli ◽  
Oliver Seitz ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Preliminary Report ◽  
Er:Yag Laser ◽  
Osteonecrosis Of The Jaw

scholarly journals Bisphosphonates-related osteonecrosis of the jaw in Korea: a preliminary report

2013 ◽  
Vol 39 (1) ◽  
pp. 9 ◽  
Author(s):  
Jeong Keun Lee ◽  
Kyung-Wook Kim ◽  
Jin-Young Choi ◽  
Seong-Yong Moon ◽  
Su-Gwan Kim ◽  
...  
Keyword(s):  
Preliminary Report ◽  
Osteonecrosis Of The Jaw

scholarly journals Impact of Bisphosphonate-related Osteonecrosis of the Jaw on Osteoporotic Patients after Dental Extraction: A Population-Based Cohort Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0120756 ◽  
Author(s):  
Yi Fang Huang ◽  
Chung Ta Chang ◽  
Chih Hsin Muo ◽  
Chun Hao Tsai ◽  
Yu Fu Shen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Osteonecrosis Of The Jaw ◽  
Dental Extraction

scholarly journals Clinical attitude regarding denosumab drug-holiday for dental extraction in oncologic patients: a national survey

2021 ◽  
Vol 27 (3) ◽  
pp. 38
Author(s):  
Claire Lainé ◽  
Aline Desoutter ◽  
Anne-Gaëlle Chaux
Keyword(s):  
Median Duration ◽  
National Survey ◽  
Surgical Procedure ◽  
Tooth Extraction ◽  
Healthcare Professionals ◽  
Osteonecrosis Of The Jaw ◽  
Drug Holiday ◽  
Dental Extraction ◽  
Oncologic Patients

Introduction: Denosumab is indicated in oncology to reduce tumoral development. However, this medication may cause osteonecrosis of the jaw, especially after dental extractions. Drug holiday has been proposed to decrease the risk of osteonecrosis of the jaw. This survey aimed to assess the management of drug holidays for patients who needed both dental extraction and denosumab. Methods: A questionnaire was sent to a panel of healthcare professionals. Results: Of the 33 practitioners interviewed, 28 undertook or “were used to” dental extractions in patients on denosumab. 25% (7/28) of the practitioners questioned did not stop patients from taking denosumab before dental extraction and 75% (21/28) used a drug holiday. For those who stopped the treatment, 33% (7/21) waited 2 months before performing dental extraction and 38% (8/21) waited 2 months after the dental extraction before reintroducing the molecule; 2 months being the median duration in both cases. In addition, 89% (25/28) of practitioners, modified their surgical procedure for these patients. Conclusion: Despite a small number of responders, it seemed that a drug holiday of at least 2 months is mandatory before performing tooth extraction. The issue of the drug holiday should always be raised with the patient's oncologist.

The Incidence of Osteonecrosis of the Jaw (ONJ) in Patients with Multiple Myeloma Who Receive Biphosphonates Depends on the Type of Biphosphonate.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 637-637 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Efstathios Kastritis ◽  
Lia A. Moulopoulos ◽  
Ioannis Melakopoulos ◽  
Athanasios Anagnostopoulos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Zoledronic Acid ◽  
Median Number ◽  
Osteonecrosis Of The Jaw ◽  
Accurate Estimate ◽  
Dental Extraction ◽  
Bone Lesions ◽  
Cumulative Hazard ◽  
True Incidence ◽  
Sequential Administration

Abstract Purpose: Biphosphonates have been approved for the treatment of bone lesions in patients with multiple myeloma. Although these agents are usually well tolerated, osteonecrosis of the jaw (ONJ) has been recently associated with the use of pamidronate and zoledronic acid. Nevertheless, the true incidence of this complication is not clearly defined. Therefore, we studied the incidence, characteristics and risk factors for the development of ONJ among patients with multiple myeloma treated with biphosphonates in our institution. Patients and Methods: One hundred and thirty-seven patients who received biphosphonates (zoledronic acid: 50 pts, pamidronate: 29 patients, bondronate: 2 pts, pamidronate and zoledronic acid: 50 pts, zoledronic acid and bondronate: 5 pts) since January 1995 and had a minimum exposure of 6 months to the drug were included in this analysis. Since the first reports, which associated ONJ with biphosphonate treatment, we prospectively evaluated this complication (first patient diagnosed in July 2003): all patients complaining of symptoms suggestive of ONJ were referred to a maxillofascial surgeon who confirmed the diagnosis and managed the patients for this complication. The medical records of all patients who were included in the analysis were reviewed in order to exclude symptoms and signs of ONJ, which might have not been formally diagnosed. From this retrospective review, no patient with a highly probable diagnosis of ONJ was identified. Results: Ten patients (6.7%) developed ONJ. The median number of treatment cycles and time of exposure to biphosphonates were 26 infusions and 42 months for patients with ONJ compared to19 infusions (p=0.2) and 27 months (p=0.05) for patients with no ONJ. The cumulative hazard of ONJ increased with time to exposure from 0% for exposure 6–12 months to 13% (95% CI: 3–23) for exposure of 5 years. The use of thalidomide was not associated with the development of ONJ. No case of ONJ was observed among patients treated with pamidronate or pamidronate and ibandronate. In patients who received sequential pamidronate and zoledronic acid, all cases of ONJ occurred during the use of zoledronic acid. The cumulative hazard was significantly higher with zoledronic acid compared to pamidronate alone or sequential administration of pamidronate and zoledronic acid (p=0.022). Among the 10 patients, who developed ONJ, 7 had had dental extraction prior to the development of the complication, 2 had dentures and only one had not had either. In spite of the discontinuation of biphosphonate treatment, only one patient experienced improvement of osteonecrosis, in 7 cases it remained stable and in 2 cases osteonecrosis progressed. Conclusions: The use of biphosphonates in patients with multiple myeloma seems to be associated with the development of ONJ. Our cohort study is the first one which provides a fairly accurate estimate of the incidence of documented ONJ after treatment with biphosphonates. Length of exposure and the type of biphosphonate used appear to be the most important risk factor for this complication. The risk of developing osteonecrosis appears to be higher with zoledronic acid than with pamidronate and may be precipitated by dental extraction.

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