Osteonecrosis of the Maxilla and Mandible in Patients with Advanced Cancer Treated with Bisphosphonate Therapy CHERRY L. ESTILO, a CATHERINE H. VAN POZNAK, b TIJAANA WILIAMS, a GEORGE C. BOHLE, a PHYU T. LWIN, a QIN ZHOU, c ELYN R. RIEDEL, c DIANE L. CARLSON, d HEIKO SCHODER, e AZEEZ FAROOKI, f MONICA FORNIER, g JERRY L. HALPERN, a STEVEN J. TUNICK, a JOSEPH M. HURYN a a Dental Service, Department of Surgery, c Department of Epidemiology and Biostatistics, d Surgical Pathology Service, Department of Pathology, e Nuclear Medicine Service, Department of Radiology, f Endocrinology Service, Department of Medicine, and g Breast Cancer Medicine Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; b Department of Internal Medicine, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, USA Key Words. Bisphosphonate therapy • Pamidronate • Zoledronic acid • Osteonecrosis of the jaw Disclosure: C.L.E. is a participating investigator in a Novartis-sponsored zoledronic acid trial, CZOL446E2352. C.H.V.P. has served as a consultant for Amgen and Roche and is a participating investigator in a Novartis-sponsored zoledronic acid trial, CZOL446E2352. J.M.H. is a consultant to Novartis and a member of the Data Monitoring Committee for the zoledronic acid trial CZOL446E2352. A.F. is on the speaker’s bureau for Novartis. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers. LEARNING OBJECTIVES After completing this course, the reader should be able to: 1. Define the indications for i.v. bisphosphonate therapy. 2. Assess the clinical features of osteonecrosis of the jaw. 3. Manage osteonecrosis of the jaw. This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACT Cases of osteonecrosis of the jaw (ONJ) have been re- ported with an increasing frequency over the past 5 years. ONJ is most often identified in patients with can- cer who are receiving intravenous bisphosphonate (IVBP) therapy, but it has also been diagnosed in pa- tients receiving oral bisphosphonates for nonmalignant conditions. To further categorize risk factors associated with ONJ and potential clinical outcomes of this condi- tion, we performed a retrospective study of patients with metastatic bone disease treated with intravenous bisphosphonates who have been evaluated by the Me- morial Sloan-Kettering Cancer Center Dental Service between January 1, 1996 and January 31, 2006. We identified 310 patients who met these criteria. Twenty- eight patients were identified as having ONJ at presen- tation to the Dental Service and an additional 7 patients Correspondence: Cherry L. Estilo, D.M.D., Dental Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA. Telephone: 212-639-7644; Fax: 212-717-3601; e-mail: estiloc@mskcc.org Received April 14, 2008; accepted for publication July 10, 2008; first published online in THE ONCOLOGIST Express on August 11, 2008. ©AlphaMed Press 1083-7159/2008/$30.00/0 doi: 10.1634/theoncologist.2008-0091 T he O ncologist ® Symptom Management and Supportive Care The Oncologist 2008;13:000 – 000 www.TheOncologist.com Published Ahead of Print on August 11, 2008 as 10.1634/theoncologist.2008-0091. by guest on November 9, 2015 http://theoncologist.alphamedpress.org/ Downloaded from