Alveolar bone histological necrosis observed prior to extractions in patients, who received bone-targeting agents.

Ourania Nicolatou-Galitis, Erofili Papadopoulou, Emmanouil Vardas, Maria Kouri, Dimitra Galiti, Evangelos Galitis, Konstantina-Eleni Alexiou, Kostas Tsiklakis, Alexandros Ardavanis, Evangelia Razis, Ilias Athanasiadis, Stavroula Droufakou, Amanda Psyrri, Michalis V. Karamouzis, Helena Linardou, Danai Daliani, Dimitrios Tzanninis, Sotirios Sachanas, Konstantinos Laschos, Marie-Christine KyrtsonisFotini Antoniou, Apostolos Laskarakis, Styllianos Giassas, Adamantia Nikolaidi, George Rigakos, Anna Ntokou, Cesar A. Migliorati, Carla I. Ripamonti

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: We reported the alveolar bone histology prior to dental extractions in cancer patients, who received bone-targeting agents (BTA). SUBJECTS AND METHODS: Fifty-four patients were included. Patients underwent extractions, and bone biopsies were taken. RESULTS: Extractions were performed due to pain, swelling, purulence, fistula, and numbness, not responding to treatment, in 40 patients (group A); extractions due to asymptomatic, non-restorable teeth, were performed in 14 patients (group B). Complete alveolar jaw bone histological necrosis was observed in 28 of 40 (70 patients of group A and none of group B (p textless .001). The development of clinical osteonecrosis (MRON) was assessed in 44 patients; 10 patients, who were also treated with Low Level Laser Treatments-LLLT, were excluded from this analysis, as the alternative therapies were a confounding factor. Twelve patients, with alveolar bone histological necrosis prior to extraction, developed medication-related osteonecrosis of the jaw (MRONJ) compared with two patients with vital or mixed vital/non-vital bone (p textless .0007). BTAs textgreater1 year and concurrent targeted therapy were also significantly associated with MRONJ (p = .016 and p = .050). CONCLUSION: Pain, swelling, purulence, fistula, and numbness were significantly associated with complete bone histological necrosis prior to extractions and increased MRONJ development. Research is justified to explore whether histological necrosis represents an early stage of osteonecrosis.
Original languageEnglish
JournalOral Diseases
Issue number5
Publication statusPublished - Jul 1 2020

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