Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma

被引：11
作者：
Choi W.-S. [1 ]
Lee J.-I. [2 ]
Yoon H.-J. [3 ]
Min C.-K. [4 ]
Lee S.-H. [5 ]
机构：
[1] Department of Oral and Maxillofacial Surgery, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan
[2] Department of Oral and Maxillofacial Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul
[3] Department of Oral and Maxillofacial Surgery, College of Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon
[4] Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul
[5] Department of Dentistry, St. Paul’s Hospital, College of Medicine The Catholic University of Korea, 180 Wangsan-ro, Seoul, Dongdaemun-gu
来源：
Maxillofacial Plastic and Reconstructive Surgery | / 39卷 / 1期
基金：
中国国家自然科学基金;
关键词：
Bisphosphonate; Medication-related necrosis of the jaw; Multiple myeloma;
D O I：
10.1186/s40902-016-0099-4
中图分类号：
学科分类号：
摘要：
Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy. © 2017, The Author(s).
引用
收藏
相关论文
共 27 条
[1]  
Tricot G., Multiple myeloma and other plasma cell disorders. Hematology: basic principles and practice, pp. 1398-1416, (2000)
[2]  
Won Y.J., Sung J., Jung K.W., Kong H.J., Park S., Shin H.R., Park E.C., Ahn Y.O., Hwang I.K., Lee D.H., Nationwide cancer incidence in Korea, 2003-2005, Cancer Res Treat, 41, pp. 122-131, (2009)
[3]  
Mhaskar R., Redzepovic J., Wheatley K., Clark O.A., Miladinovic B., Glasmacher A., Kumar A., Djulbegovic B., Bisphosphonates in multiple myeloma: A network meta-analysis, Cochrane Database Rev, 16, (2012)
[4]  
Ruggiero S.L., Mehrotra B., Rosenberg T.J., Engroff S.L., Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases, J Oral Maxillofac Surg, 62, pp. 527-534, (2004)
[5]  
Badros A., Weikel D., Salama A., Goloubeva O., Schneider A., Rapoport A., Fenton R., Gahres N., Sausville E., Ord R., Meiller T., Osteonecrosis of the jaw in multiple myeloma patients: clinical features and risk factors, J Clin Oncol, 24, pp. 945-952, (2006)
[6]  
Boonyapakorn T., Schirmer I., Reichart P.A., Sturm I., Massenkeil G., Bisphosphonate-induced osteonecrosis of the jaws: prospective study of 80 patients with multiple myeloma and other malignancies, Oral Oncol, 44, pp. 857-869, (2008)
[7]  
Bamias A., Kastritis E., Bamia C., Moulopoulos L.A., Melakopoulos I., Bozas G., Koutsoukou V., Gika D., Anagnostopoulos A., Papadimitriou C., Terpos E., Dimopoulos M.A., Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors, J Clin Oncol, 23, pp. 8580-8587, (2005)
[8]  
Marx R.E., Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic, J Oral Maxillofac Surg, 61, pp. 1115-1117, (2003)
[9]  
Kos M., Kuebler J.F., Luczak K., Engelke W., Bisphosphonate-related osteonecrosis of the jaws: a review of 34 cases and evaluation of risk, J Craniomaxillofac Surg, 38, pp. 255-259, (2010)
[10]  
Ruggiero S.L., Dodson T.B., Assael L.A., Landesberg R., Marx R.E., Mehrotra B., American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws—2009 update, J Oral Maxillofac Surg Suppl, 67, pp. 2-12, (2009)
123