ADA updates guidelines for managing ONJ risk patients

Source: www.drbicuspid.com Author: Rabia Mughal, Contributing Editor A patient receiving antiresorptive therapy for the prevention and treatment of osteoporosis has a low risk of developing osteonecrosis of the jaw (ONJ), and benefits of the medication outweigh the risk of ONJ, according to an advisory statement from the ADA. The statement, "Managing the Care of Patients Receiving Antiresorptive Therapy for Prevention and Treatment of Osteoporosis," is based on a literature review by an advisory committee of the ADA Council on Scientific Affairs and updates ADA's 2008 advisory statement (Journal of the American Dental Association, November 2011, Vol. 142:11, pp. 1243-1251). ONJ associated with antiresorptive agents has mostly been referred to as bisphosphonate-associated ONJ, but nonbisphosphonate antiresorptive agents are now available that also could be associated with ONJ, the panel noted. That is why they refer to the condition as antiresorptive agent-induced ONJ (ARONJ). A relatively new condition, bisphosphonate-associated ONJ, has received tremendous media attention because of a flurry of lawsuits against the makers of Fosamax and Zometa alleging that the medications led to ONJ. These lawsuits have been a factor in raising patients' and dentists' awareness of the condition, according to Helen Ristic, PhD, director of scientific information for the ADA's Division of Science and one of the panelists who contributed to the report. "The first calls the ADA received from dentists about ARONJ were in response to advertisements by lawyers and media reports," she said. Still, much about the condition remains a mystery, in part because there has not been [...]

2011-11-06T10:10:08-07:00November, 2011|Oral Cancer News|

High risk of developing ONJ for cancer patients on bisphosphonates

Source: Dr.Bicuspid.com Research has shown that cancer patients on bisphosphonates are at risk of developing osteonecrosis of the jaw (ONJ) and that those on the intravenous form of the drug are at a higher risk compared with those on the oral drugs. However, a new study that looked at cancer patients on zoledronic acid (ZOL) and chemotherapy combined with the antiangiogenic agent bevacizumab (BEV) who underwent a dental exam before starting treatment found that none of them developed ONJ (JADA, May 2011, Vol. 142:5, pp. 506-513). Researchers from the University of Siena in Italy investigated the incidence of and risk factors for ONJ in patients with metastases to the bone from solid tumors who received ZOL and BEV. Their study included 59 patients (34 with breast cancer and 25 with non-small cell lung cancer [NSCL]) who received 4 mg of ZOL intravenously every four weeks and 15 mg per kg of BEV every three weeks. The median time the participants received ZOL therapy was 18 months, while the median time participants received BEV therapy was 16 months. The researchers took several measures to reduce the study participants' risk of developing ONJ, including the following: Dental caries and periodontal disease were treated before starting study treatment. Mouth rinses with chlorhexidine and local antibiotic agents were administered before baseline oral hygiene. Recommendations were made for maintaining good oral hygiene. Teeth were extracted at least four weeks before starting ZOL and BEV therapy. Invasive dental procedures were avoided during treatment. If invasive dental [...]

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