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 [...]