Alveolar bone histological necrosis observed prior to extractions in patients, who received bone-targeting agents

Ourania Nicolatou-Galitis¹, Erofili Papadopoulou¹, Emmanouil Vardas¹, Maria Kouri¹, Dimitra Galiti², Evangelos Galitis³, Konstantina-Eleni Alexiou², Kostas Tsiklakis², Alexandros Ardavanis⁴, Evangelia Razis⁵, Ilias Athanasiadis⁶, Stavroula Droufakou⁷, Amanda Psyrri⁸, Michalis V Karamouzis⁹, Helena Linardou¹⁰, Danai Daliani¹¹, Dimitrios Tzanninis¹², Sotirios Sachanas¹³, Konstantinos Laschos¹⁴, Marie-Christine Kyrtsonis¹⁵, Fotini Antoniou¹⁶, Apostolos Laskarakis¹⁷, Styllianos Giassas¹⁸, Adamantia Nikolaidi⁶, George Rigakos⁵, Anna Ntokou⁴, Cesar A Migliorati¹⁹, Carla I Ripamonti²⁰

Affiliations

¹ Clinic of Hospital Dentistry, Densstal School, National & Kapodistrian University of Athens, Athens, Greece.
² Clinic of Oral Diagnosis & Radiology, Dental School, National & Kapodistrian University of Athens, Athens, Greece.
³ Clinic of Oral and Maxillofacial Surgery, Dental School, National & Kapodistrian University of Athens, Athens, Greece.
⁴ Oncology Department, Saint Savvas Hospital, Athens, Greece.
⁵ Third Medical Oncology Department, Hygeia Hospital, Athens, Greece.
⁶ Oncology Department, Mitera Hospital-Hygeia, Athens, Greece.
⁷ Medical Oncology Department, Hippokration Hospital, Athens, Greece.
⁸ Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece.
⁹ Department of Biological Chemistry and First Department of Internal Medicine, Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
¹⁰ Oncology Unit, Metropolitan Hospital, Athens, Greece.
¹¹ First Medical Oncology Department, Euroclinic of Athens, Athens, Greece.
¹² Department of Medical Oncology, Athens Medical Center, Athens, Greece.
¹³ Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece.
¹⁴ 2nd Oncology Department, General and Oncologic Hospital "Agii Anargyri", Athens, Greece.
¹⁵ Hematology Department, Laikon General Hospital, Athens, Greece.
¹⁶ Department of Oncology Unit, Elena Venizelou Maternity Hospital, Athens, Greece.
¹⁷ First Oncology Department, Metropolitan Hospital, Athens, Greece.
¹⁸ 2nd Oncology Clinic, IASO Maternity Hospital and 3rd Oncology Clinic, Metropolitan General Hospital, Athens, Greece.
¹⁹ Department of Diagnostic Sciences and Oral Medicine, University of Florida Health Science Center College of Dentistry, Gainesville, FL, USA.
²⁰ Supportive Care Unit, Department of Medical Oncology and Haematology, Fondazione IRRCS, Istituto Nazionale dei Tumori, Milano, Italy.

PMID: 32011077
DOI: 10.1111/odi.13294

Alveolar bone histological necrosis observed prior to extractions in patients, who received bone-targeting agents

Ourania Nicolatou-Galitis et al. Oral Dis. 2020 Jul.

. 2020 Jul;26(5):955-966.

doi: 10.1111/odi.13294. Epub 2020 Mar 3.

Authors

Affiliations

¹ Clinic of Hospital Dentistry, Densstal School, National & Kapodistrian University of Athens, Athens, Greece.
² Clinic of Oral Diagnosis & Radiology, Dental School, National & Kapodistrian University of Athens, Athens, Greece.
³ Clinic of Oral and Maxillofacial Surgery, Dental School, National & Kapodistrian University of Athens, Athens, Greece.
⁴ Oncology Department, Saint Savvas Hospital, Athens, Greece.
⁵ Third Medical Oncology Department, Hygeia Hospital, Athens, Greece.
⁶ Oncology Department, Mitera Hospital-Hygeia, Athens, Greece.
⁷ Medical Oncology Department, Hippokration Hospital, Athens, Greece.
⁸ Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece.
⁹ Department of Biological Chemistry and First Department of Internal Medicine, Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
¹⁰ Oncology Unit, Metropolitan Hospital, Athens, Greece.
¹¹ First Medical Oncology Department, Euroclinic of Athens, Athens, Greece.
¹² Department of Medical Oncology, Athens Medical Center, Athens, Greece.
¹³ Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece.
¹⁴ 2nd Oncology Department, General and Oncologic Hospital "Agii Anargyri", Athens, Greece.
¹⁵ Hematology Department, Laikon General Hospital, Athens, Greece.
¹⁶ Department of Oncology Unit, Elena Venizelou Maternity Hospital, Athens, Greece.
¹⁷ First Oncology Department, Metropolitan Hospital, Athens, Greece.
¹⁸ 2nd Oncology Clinic, IASO Maternity Hospital and 3rd Oncology Clinic, Metropolitan General Hospital, Athens, Greece.
¹⁹ Department of Diagnostic Sciences and Oral Medicine, University of Florida Health Science Center College of Dentistry, Gainesville, FL, USA.
²⁰ Supportive Care Unit, Department of Medical Oncology and Haematology, Fondazione IRRCS, Istituto Nazionale dei Tumori, Milano, Italy.

PMID: 32011077
DOI: 10.1111/odi.13294

Abstract

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.

Keywords: bone necrosis; cancer; dental extraction; dental/periodontal infection; histology; osteonecrosis of the jaw.

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References

REFERENCES

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Alveolar bone histological necrosis observed prior to extractions in patients, who received bone-targeting agents

Affiliations

Alveolar bone histological necrosis observed prior to extractions in patients, who received bone-targeting agents

Authors

Affiliations

Abstract

References

REFERENCES

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical