Oral health condition in cancer patients under bisphosphonate therapy

• Published in: Supportive care in cancer Vol. 29; no. 12; pp. 7687 - 7694
• Main Authors: Jardim Caldas, Rogério, Spíndola Antunes, Héliton, de Oliveira Rodini Pegoraro, Camila, Ribeiro Guedes, Fábio, da Silva Santos, Paulo Sérgio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2021; Springer; Springer Nature B.V
• Subjects: Bisphosphonates; Bone diseases; Cancer; Cancer patients; Care and treatment; Dental caries; Disodium pamidronate; Epidemiology; Gangrene; Gum disease; Health aspects; Hygiene; Jaw; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Nursing; Nursing Research; Oncology; Oral health; Oral hygiene; Original Article; Pain Medicine; Rehabilitation Medicine; Side effects; Oncology; Caries; Osteonecrosis; Periodontal disease(s)/periodontitis; Epidemiology; Oral hygiene
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-021-06362-y

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.