Periodontal Treatment in Cancer Patients: an Interdisciplinary Approach
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• Vehmanen L, Suojanen J, Kontio R, Utriainen T, Blomqvist C. High frequency of osteonecrosis of the jaw among denosumab-treated prostate cancer patients. Acta Oncol. 2017;56(1):104–106. These authors completed a case series with 254 men with castrate-resistant prostate cancer and treated with zolendronic acid, denosumab, or both, who also received dental extractions by oral and maxillofacial surgeons. In total, 29 out of 254 men (11.4%) developed ONJ. Of the patients who developed ONJ, 2 received only zolendronic acid, 9 received only denosumab, and 18 received both zolendronic acid and denosumab. Seventeen of the 29 ONJ cases had chronic disability of the jaw or jaw necrosis that continued until the death of the patient. https://doi.org/10.1080/0284186X.2016.1262548 .
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• Owosho AA, Tsai CJ, Lee RS, Freymiller H, Kadempour A, Varthis S, et al. The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): the Memorial Sloan Kettering Cancer Center experience. Oral Oncol. 2017;64:44–51. These authors completed a case-control study at the Memorial Sloan Kettering Cancer Center. The authors determined the prevalence of ORN to be 4.3% during a median follow-up time of 52.5 months. Furthermore, the authors stated that patients treated for oropharyngeal cancer were prone to develop ORN earlier compared to patients with oral cavity cancer. In addition, these authors reported that poor periodontal status, history of alcohol use, and radiation dose were significant risk factors. https://doi.org/10.1016/j.oraloncology.2016.11.015 .
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• Dieleman F, Phan T, van den Hoogen F, Kaanders J, Merkx M. The efficacy of hyperbaric oxygen therapy related to the clinical stage of osteoradionecrosis of the mandible. Int J Oral Maxillofac Surg. 2017;46(4):428–433. These authors completed a retrospective study and reported that the cause of ORN was most commonly extractions after radiation therapy (22%) or prosthetics (22%) followed by periodontal disease (11%) and tumor-related surgery (11%). Interestingly, treatment with hyperbaric oxygen is only significantly effective for lower stages of ORN, while higher stages of ORN still require segmental resection of the affected structure. https://doi.org/10.1016/j.ijom.2016.12.004 .
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NIDCR. Cancer Treatment and Oral Health. 2017. https://www.nidcr.nih.gov/OralHealth/Topics/CancerTreatment/