Avascular jaw osteonecrosis in association with cancer chemotherapy: series of 10 cases

• Published in: Journal of oral pathology & medicine Vol. 34; no. 2; pp. 120 - 123
• Main Authors: Bagan, J. V., Murillo, J., Jimenez, Y., Poveda, R., Milian, M. A., Sanchis, J. M., Silvestre, F. J., Scully, C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01-02-2005; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; bisphosphonates; Bone Neoplasms - drug therapy; Bone Neoplasms - secondary; Breast Neoplasms - pathology; cancer; chemotherapy; Diphosphonates - adverse effects; Diseases of the osteoarticular system; Female; Humans; Jaw Diseases - chemically induced; jaws; Male; Medical sciences; Middle Aged; Multiple Myeloma - pathology; osteonecrosis; Osteonecrosis - chemically induced; Otorhinolaryngology. Stomatology; Vascular bone diseases; Antineoplastic agent; Human; Jaw; jaws; Stomatology; Diseases of the osteoarticular system; Maxillary; ENT; Osteonecrosis; Malignant tumor; Chemotherapy; Treatment; Complication; bisphosphonates; cancer
• ISSN: 0904-2512; 1600-0714
• DOI: 10.1111/j.1600-0714.2004.00269.x

Background:  We present a series of 10 patients with osteonecrosis of the jaws (ONJ) that appeared following cancer chemotherapy.
Material and methods:  Of the 10 cases with ONJ, six had bone metastases from breast cancers and the other four had multiple myeloma. We analysed the location of bone metastases, as well as the characteristics of the ONJ, and the drugs with which they had been treated for their bone metastases.
Results:  Of the 10 patients, all had ONJ in the mandible; 50% also had maxillary involvement. The average number of areas of painful exposed was 2.1 per patient (range 1–5). In seven patients a tooth extraction preceded the onset of ONJ. Two patients developed oroantral communications and another a cutaneous fistula to the neck with suppuration. In all the 10 patients the histopatholological diagnosis was of chronic osteomyelitis without evidence of metastatic disease to the jaws. All the patients had received treatment for their malignant bone disease with bisphosphonates. These were the only drugs that all patients had received.
Conclusion:  ONJ appears to have a relationship with the use of bisphosphonates.