engleski

Dental workup of oncology patients before bisphosphonate therapy - retrospective study

Introduction: Medication related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive and/or antiangiogenic therapy. Main risk factor for MRONJ is tooth extraction. In order to minimize the risk for MRONJ development, patients need to undergo dental evaluation and complete dental treatment prior to the beginning of the antiresorptive treatment. Aim: To review the data on dental workup in a cohort of oncology patients scheduled for bisphosphonate therapy. Materials and methods: Retrospective chart review of oncology patients referred to a dental evaluation before the onset of antiresorptive therapy at the Dental Unit of the University Clinical Hospital Centre Zagreb from 1.1.2017- 31.12.2019, was performed. Following data were registered: age, gender, diagnosis, DMFT, number of teeth for extraction, type of extraction, antibiotic treatment, postoperative complications, number of appointments and time needed to obtain dentist's clearance for the introduction of bisphposphonate therapy. Results: Thirty oncology patients (mean age 63.9) participated in the study. Average DMFT index was 20 ± 6.8. Twenty four (80%) patients needed one or more dental extraction. Average number of extractions per patient was 2.8 ± 2.8. None of the patients experienced post operative complications. Average number of appointments was 2.2 ± 1.1. Average number of days to obtain dentist's clearance for the beginning of bisphosphonate therapy was 12.9 ± 15.7. Conclusion: Majority of oncology patients with metastatic disease in this study needed one or more dental extraction before commencing bisphosphonate therapy. Dental treatment of the majority of patients can be completed within 14 days, which does not lead to a significant treatment delay while significantly reducing the risk for MRONJ development.

tooth extraction ; osteonecrosis of the jaw ; prevention ; bisphosphonate therapy

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