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Oral health condition in cancer patients under bisphosphonate therapy

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Abstract

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.

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All data and materials supporting the published claims in this paper are available to be verified if necessary.

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Funding

This work was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001. The funding source was not involved in the conduct of the research and/or preparation of this article.

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Authors and Affiliations

  1. Department of Dentistry, Mario Kroeff Hospital, Rio de Janeiro, Brazil

    Rogério Jardim Caldas

  2. Department of Surgery, Stomatology, Pathology and Radiology, University of Sao Paulo, Bauru School of Dentistry, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil

    Rogério Jardim Caldas & Paulo Sérgio da Silva Santos

  3. Division of Clinical Research and Technological Development, National Institute of Cancer, Rio de Janeiro, Brazil

    Héliton Spíndola Antunes

  4. Department of Biological Sciences, University of Sao Paulo, Bauru School of Dentistry, Bauru, Brazil

    Camila de Oliveira Rodini Pegoraro

  5. Faculty of Dentistry, Department of Pathology and Oral Diagnosis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Fábio Ribeiro Guedes

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  1. Rogério Jardim Caldas
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  2. Héliton Spíndola Antunes
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  5. Paulo Sérgio da Silva Santos
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Contributions

Rogério Jardim Caldas: Contributed to conception, design, data acquisition and interpretation, performed all statistical analyses, drafted, and critically revised the manuscript

Héliton Spíndola Antunes: Contributed to conception, design, data acquisition and interpretation, performed all statistical analyses, and critically revised the manuscript

Camila de Oliveira Rodini Pegoraro: Contributed to data interpretation and critically revised the manuscript

Fábio Ribeiro Guedes: Contributed to data interpretation and critically revised the manuscript

Paulo Sérgio da Silva Santos: Contributed to conception, design, data interpretation, and critically revised the manuscript

All authors gave their final approval and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Rogério Jardim Caldas.

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Ethics approval

This multicenter study was conducted in accordance with the ethical principles of the World Medical Association and 1964 Helsinki Declaration and was approved by the Research Ethics Committee of the involved institutions by registration number CAEE44723715.7.1001.527.

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All research participants received detailed explanations with appropriate language to their comprehension and freely decided to participate in the research, signing the informed consent form. The procedures used on all participants were performed after obtaining the signed consent form.

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Conflict of interest

The first author received a scholarship from CAPES during the research period. The other authors declare that they have no conflict of interest with respect to the authorship and/or publication of this article.

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Jardim Caldas, R., Spíndola Antunes, H., de Oliveira Rodini Pegoraro, C. et al. Oral health condition in cancer patients under bisphosphonate therapy. Support Care Cancer 29, 7687–7694 (2021). https://doi.org/10.1007/s00520-021-06362-y

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