Oral care and the use of bone-targeted agents in patients with metastatic cancers: A practical guide for dental surgeons and oncologists

Journal of Bone Oncology
Iryna KuchukMark Clemons

Abstract

Bone-targeted agents such as bisphosphonates and the RANKL antibody have revolutionised the care of patients with bone metastases. There has, however been increasing concern about the oral health of these patients and in particular osteonecrosis of the jaw (ONJ), especially with the increasing use of these agents at higher potencies for greater periods of time. A review of the published data in PubMed and meeting abstracts was performed to examine incidence, risk factors, pathogenesis, clinical course and management of osteonecrosis of the jaw with focus on cancer patients treated with bone-targeted agents (BTA) for bone metastases. This manuscript takes the most frequent and pertinent questions raised by oncologists, dentists and oral and maxillofacial surgeons and tries to give a pragmatic overview of the literature. The incidence of ONJ varies depending on types of bone-targeted agents, duration of treatment and additional risk factors. The causes and pathogenesis of ONJ is not fully elucidated, however bone-targeted therapy induced impaired bone remodelling, microtrauma secondary to jaw activity, and oral bacterial infection seem to be important factors. Since the treatment options for ONJ are limited and not well establish...Continue Reading

Citations

Aug 15, 2014·Current Opinion in Supportive and Palliative Care·Carmel JacobsMark Clemons
Apr 25, 2018·Mediators of Inflammation·Anna PiccaEmanuele Marzetti
Feb 18, 2020·Journal of Dental Education·Abdulhaq Abdulmajeed SulimanHussein Abdulsalam Elmasmari
Mar 29, 2014·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Joel B EpsteinAndrei Barasch
Aug 5, 2016·Cranio : the Journal of Craniomandibular Practice·Larry Weeda
Jan 1, 2013·Journal of Clinical Medicine·Demetrios SimosMark Clemons
Mar 29, 2014·Expert Opinion on Pharmacotherapy·Carmel JacobsMark Clemons
Jun 23, 2018·Frontiers in Endocrinology·Salvatore J Coniglio
Jul 1, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M F K IbrahimM Clemons

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