Cancer patients on IV bisphosphonates need dental evaluation

Because breast cancer patients receiving intravenous bisphosphonates may be at higher risk of developing osteonecrosis of the jaws (ONJ), they should receive early referral by oncologists for baseline dental evaluation, according to a report published online June 23 in the Journal of Clinical Oncology.

Athanassios Kyrgidis, MD, of Aristotle University, AHEPA Hospital in Thessaloniki, Greece, and colleagues conducted a case-control study of 20 breast cancer patients who developed ONJ while receiving bisphosphonates and 40 breast cancer patients who did not develop ONJ while receiving bisphosphonates. The researchers found that the risk factors for developing ONJ were tooth extraction during zoledronic acid treatment and the use of dentures (adjusted OR, 16.4 and 4.9, respectively).
“Regular dental follow-up to avoid tooth extractions might play a protective role in the prevention of ONJ development,” the authors write. These results “raise the current level of evidence linking dental-specific procedures with bisphosphonate-induced ONJ from V to III. Further studies are needed to assess other potential risk factors and also to highlight the etiopathogenesis mechanism of ONJ.”

Kyrgidis A, Vahtsevanos K, Koloutsos G, et al. Bisphosphonate-related osteonecrosis of the jaws: a case-control study of risk factors in breast cancer patients. J Clin Oncol. 2008. Published online at 10.1200/JCO.2008.16.2768. Available at: http://jco.ascopubs.org/cgi/content/abstract/JCO.2008.16.2768v1. Accessed August 6, 2008.