Objectives: Osteonecrosis of the jaw (ONJ) is a concern in patients taking anti-resorptive drugs. The aim of this study was to test the hypothesis that preoperative individualized pharmacologic control of the patient's osteometabolic profile could lead to predictable healing of the surgically treated region and minimize the incidence of complications. Study Design: This prospective study included 95 test patients (53 with osteoporosis and 42 with cancer), and 94 control patients (49 with osteoporosis and 45 with cancer) who were on anti-resorptive therapy and were candidates for ONJ treatment. Test patients underwent osteometabolic profile assessment and personalized pharmacologic supplementation before intervention. In all cases, a drug holiday was scheduled for 3 months before and at least 3 months after the intervention. Healing was assessed clinically and radiographically. Results: In the test group, after a mean follow-up of 28.2 ± 7.8 months, there was only 1 ONJ recurrence, and it was successfully resolved after the pharmacologic protocol was resumed. Five patients reported minor complications. Overall, 100% treatment success was observed. In the control group, after 28.1 ± 4.9 months follow-up, 6 fistulae, 19 abscesses, and 34 dehiscences occurred. In total, 62.8% of patients in the control group had complications or adverse events. The difference between the 2 groups was highly significant. Conclusions: Strict osteometabolic control should be a routine measure in the management of patients taking anti-resorptive drugs.

Patients’ osteometabolic control improves the management of medication-related osteonecrosis of the jaw / G. Colapinto, R. Volpi, G. Forino, V. Tricarico, M. De Benedittis, R. Cortelazzi, T. Testori, M. Del Fabbro. - In: ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY AND ORAL RADIOLOGY. - ISSN 2212-4403. - 125:2(2018), pp. 147-156.

Patients’ osteometabolic control improves the management of medication-related osteonecrosis of the jaw

M. Del Fabbro
Ultimo
2018

Abstract

Objectives: Osteonecrosis of the jaw (ONJ) is a concern in patients taking anti-resorptive drugs. The aim of this study was to test the hypothesis that preoperative individualized pharmacologic control of the patient's osteometabolic profile could lead to predictable healing of the surgically treated region and minimize the incidence of complications. Study Design: This prospective study included 95 test patients (53 with osteoporosis and 42 with cancer), and 94 control patients (49 with osteoporosis and 45 with cancer) who were on anti-resorptive therapy and were candidates for ONJ treatment. Test patients underwent osteometabolic profile assessment and personalized pharmacologic supplementation before intervention. In all cases, a drug holiday was scheduled for 3 months before and at least 3 months after the intervention. Healing was assessed clinically and radiographically. Results: In the test group, after a mean follow-up of 28.2 ± 7.8 months, there was only 1 ONJ recurrence, and it was successfully resolved after the pharmacologic protocol was resumed. Five patients reported minor complications. Overall, 100% treatment success was observed. In the control group, after 28.1 ± 4.9 months follow-up, 6 fistulae, 19 abscesses, and 34 dehiscences occurred. In total, 62.8% of patients in the control group had complications or adverse events. The difference between the 2 groups was highly significant. Conclusions: Strict osteometabolic control should be a routine measure in the management of patients taking anti-resorptive drugs.
Adult; Aged; Aged, 80 and over; Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Female; Humans; Male; Middle Aged; Prospective Studies; Treatment Outcome; Precision Medicine; Surgery; Oral Surgery; 2734; Dentistry (miscellaneous)3502 Dental Assisting; Radiology, Nuclear Medicine and Imaging
Settore MED/50 - Scienze Tecniche Mediche Applicate
Settore MED/28 - Malattie Odontostomatologiche
Settore MED/29 - Chirurgia Maxillofacciale
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/619136
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