Cancers | Free Full-Text | Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study
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Open AccessArticle
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Department of Clinical Oncology, Wroclaw Medical University, 50-556 Wrocław, Poland
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Old Town Clinic, 50-136 Wrocław, Poland
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Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wrocław, Poland
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Department of Prosthetic Dentistry, Wroclaw Medical University, 50-425 Wrocław, Poland
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Faculty of Information and Communication Technology, Wrocław University of Science and Technology Centre for Scientific and Technical Knowledge and Information, 50-370 Wrocław, Poland
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Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, 60-512 Poznan, Poland
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1st Department of Gynecology and Obstetrics, Wroclaw Medical University, 50-599 Wroclaw, Poland
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Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland
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Department of Physiotherapy, University School of Physical Education, 51-612 Wroclaw, Poland
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Authors to whom correspondence should be addressed.
Submission received: 18 January 2024
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Revised: 20 February 2024
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Accepted: 29 February 2024
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Published: 11 March 2024
Simple Summary
This study delves into bisphosphonate therapy’s effects on oral health in 80 breast and prostate cancer patients with bone metastases. Bisphosphonates, crucial for managing skeletal complications, are linked to bisphosphonate-related osteonecrosis of the jaw (BRONJ), presenting in 0.8–18.5% of patients with symptoms like pain, tissue swelling, and tooth mobility. Through dental and radiological assessments—including DMFT and OHI-S indices, periodontal measurements, and panoramic X-rays—the research uncovers a notable decline in oral hygiene post-therapy, evidenced by worsened DMFT, OHI-S, PD, and CAL scores. Additionally, radiological changes hint at bisphosphonates’ impact on bone density and structure. Despite no significant changes in TMJ function, the findings underscore the need for ongoing dental care and risk mitigation strategies for BRONJ, emphasizing the vital role of regular dental monitoring and proactive oral hygiene practices in the comprehensive care of cancer patients undergoing bisphosphonate therapy.
Abstract
This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8–18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner’s classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates’ impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates’ long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer.
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MDPI and ACS Style
Calik, J.; Calik, K.; Sauer, N.; Zdzisław, B.; Giedziun, P.; Mackiewicz, J.; Murawski, M.; Dzięgiel, P.
Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study. Cancers 2024, 16, 1124.
https://doi.org/10.3390/cancers16061124
AMA Style
Calik J, Calik K, Sauer N, Zdzisław B, Giedziun P, Mackiewicz J, Murawski M, Dzięgiel P.
Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study. Cancers. 2024; 16(6):1124.
https://doi.org/10.3390/cancers16061124
Chicago/Turabian Style
Calik, Jacek, Katarzyna Calik, Natalia Sauer, Bogucki Zdzisław, Piotr Giedziun, Jacek Mackiewicz, Marek Murawski, and Piotr Dzięgiel.
2024. “Impact of Bisphosphonate Therapy on Oral Health in Patients with Breast and Prostate Cancer and Bone Metastases: A Comprehensive Study” Cancers 16, no. 6: 1124.
https://doi.org/10.3390/cancers16061124
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