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Multicenter Study
. 2021 Dec;29(12):7687-7694.
doi: 10.1007/s00520-021-06362-y. Epub 2021 Jun 18.

Oral health condition in cancer patients under bisphosphonate therapy

Rogério Jardim Caldas  1   2 , Héliton Spíndola Antunes  3 , Camila de Oliveira Rodini Pegoraro  4 , Fábio Ribeiro Guedes  5 , Paulo Sérgio da Silva Santos  6
Affiliations
Multicenter Study

Oral health condition in cancer patients under bisphosphonate therapy

Rogério Jardim Caldas et al. Support Care Cancer. 2021 Dec.

Abstract

Objectives: To investigate the association of oral health condition with the occurrence of medication-related osteonecrosis of the jaw (MRONJ) in a cancer population.

Methods: A multicenter cross-sectional study was conducted with cancer patients exposed to bisphosphonates for at least 7 months. Dental and periodontal conditions were assessed by epidemiological indices.

Results: The sample consisted of 80 patients under bisphosphonate therapy, nine of which were allocated to group 1 (with MRONJ) and 71 to group 2 (without MRONJ). Osteonecrosis cases presented 19 decayed, missing, and filled teeth on average. Moderate gingival inflammation was noted in both groups and together with severe inflammation exceeded 50% of the groups. The presence of dental calculus was detected in about half of the individuals in both groups. Shallow periodontal pockets were detected in about 25% of both groups. Deep periodontal pockets were more prevalent among patients with osteonecrosis. Regular oral hygiene was detected in approximately 25% of individuals in both groups. There was a strong positive correlation between the clinical staging of osteonecrosis and decayed, missing, and filled teeth index (DMFTI).

Conclusions: Patients had a poor oral health condition. All but one osteonecrosis case had no previous history of tooth extraction; oral infections seemed to play a major role in the development of bone necrosis. Advanced osteonecrosis stages were associated with a higher DMFTI.

Keywords: Caries; Epidemiology; Oncology; Oral hygiene; Osteonecrosis; Periodontal disease(s)/periodontitis.

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