Osteonecrosis of the jaw associated with cancer treatment is frequently misunderstood, according to Cesar Augusto Migliorati, DDS, MS, PhD, who delivered an update on its proper recognition and management at the 2015 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer in Copenhagen.1 Dr. Migliorati dispelled some common myths about osteonecrosis of the jaw and presented information that may be new to many clinicians.
Currently, several agents are recognized as being associated with osteonecrosis of the jaw, including bisphosphonates, denosumab (Prolia, Xgeva), and antiangiogenics. “A lot of people still call it bisphosphonate-associated osteonecrosis of the jaw, but it’s no longer a bisphosphonate problem only,” said Dr. Migliorati, Professor and Chair, Department of Diagnostic Sciences and Oral Medicine, University of Tennessee Health Science Center, Memphis.
“Further, we know now that if you combine bisphosphonates with antiangiogenics in advanced renal tumors, there is an increased risk for this condition to occur. So that’s another new recognized risk factor for this condition,” he added.
The presence of certain factors may place patients at higher risk for osteonecrosis of the jaw, warned Dr. Migliorati. They include the use of medications for osteoporosis or cancer that have been associated with osteonecrosis of the jaw, the presence of active dental/periodontal disease, and individual predisposition. The latter “should be considered since the majority of patients on these medications do not develop osteon...