Table of Contents
ISRN Oncology
Volume 2013, Article ID 672027, 8 pages
Clinical Study

Decreasing Frequency of Osteonecrosis of the Jaw in Cancer and Myeloma Patients Treated with Bisphosphonates: The Experience of the Oncology Network of Piedmont and Aosta Valley (North-Western Italy)

1Medical Oncology Unit, Department of Oncology and Hematology, Ospedale SS Antonio e Biagio e C Arrigo, Via Venezia 16, 15121 Alessandria, Italy
2Unit of Cancer Epidemiology, S. Giovanni Battista-Molinette and CPO-Corso Bramante 88, 10126 Piedmont, Turin, Italy
3Oncology Unit, University of Brescia, Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy
4Oncology Unit, IRCC Candiolo, Strada Provinciale 142, 10060 Candiolo, Turin, Italy
5Oncology Unit, S. Giovanni Battista, Molinette, Corso Bramante 88, 10126 Turin, Italy
6Oral Surgery Unit, S. Giovanni Battista, Molinette, Corso Bramante 88, 10126 Turin, Italy
7Oral Care Unit, Mauriziano Hospital, Via Magellano 1, 10126 Turin, Italy
8Dental Clinic, Department of Health Science, University of Eastern Piedmont “A. Avogadro”, Via Solaroli 17, 28100 Novara, Italy
9Hematology Unit, Department of Oncology and Hematology, Ospedale SS Antonio e Biagio e Cesare Arrigo Hospital, Via Venezia 16, 15121 Alessandria, Italy
10Hematology Unit, Turin University, Corso Bramante 88, 10126 Turin, Italy
11“Rete Oncologica di Piemonte e Valle d’Aosta” Oncology Network, Azienda Ospedaliero Universitaria San Giovanni Battista-Presidio San Lazzaro, Via Cherasco 23, 10126 Turin, Italy

Received 28 December 2012; Accepted 18 January 2013

Academic Editors: Z. S. Guo and V. Lorusso

Copyright © 2013 Vittorio Fusco et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Data concerning frequency of Osteonecrosis of Jaws (ONJ) are mostly based on single center experiences. Patients and Methods. Since 2005 a multidisciplinary study group collected data of cases of ONJ in patients treated with Bisphosphonates (BP) and observed in oncology and hematology centers of a regional network. Results. By December 2008, 221 cases were registered. We report details of 200 cases, identified after cross-checking reports from centres of medical oncology, haematology, and oral care. Primary neoplasm was breast cancer (39%), myeloma (32%), prostate cancer (16%), and other types of cancer (8%). In about 50% of the cases a history of dental extraction was present. Zoledronic acid was administered (alone or with other BP) to 178 patients (89%). Median time from first infusion to ONJ diagnosis was 21.0 (zoledronic acid only) and 39.0 months (pamidronate only). The number of ONJ cases per year was 3 in 2003, 21 in 2004, 58 in 2005, 60 in 2006, 37 in 2007, and 21 in 2008. Conclusion. The number of new ONJ cases in cancer and myeloma patients increased until 2006 and then reduced. The possible reasons of this trend (introduction of zoledronic acid; increase of ONJ awareness; diffusion of preventive dental measures; late modifications of BP prescription) are herein discussed.