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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-01222021-162158


Thesis type
Tesi di dottorato di ricerca
Author
NISI, MARCO
URN
etd-01222021-162158
Thesis title
The impact of a program of primary prevention in a dental setting on the incidence of osteonecrosis of the jaw in patients treated with zoledronic acid for bone metastases
Academic discipline
MED/28
Course of study
FISIOPATOLOGIA CLINICA
Supervisors
tutor Prof. Gabriele, Mario
Keywords
  • dental prevention
  • Osteonecrosis of the jaw
Graduation session start date
25/01/2021
Availability
Withheld
Release date
25/01/2091
Summary
Aim. The aim of the study was to investigate the incidence of medical related
osteonecrosis of the jaw (MRONJ) after the set-up of structured programme of primary
prevention before commencement and during treatment with zoledronic acid therapy taken
for the treatment of bone metastasis in oncologic patients.
Methods. In a prospective cohort study performed at the unit of dentistry and oral surgery
of the university of Pisa, from September 2017 until September 2018, all patients with
cancer with radiographic evidence of bone metastases and eligible for treatment with
zoledronic acid were included and followed up until September 31, 2020.
Results. Of the 300 patients, MRONJ developed in 7 (2.3%) during the 24 months of
study. Female gender (OR 4.4; 95% CI 1.8-22,1; P = .043) and statin treatment (OR 25.1;
95% CI 0.1-2822; P < 0.001) were associated with an increased risk of MRONJ.
Conclusions. In conclusion, MRONJ remains a significant risk associated with the use of
antiresorptive drugs in the setting of malignancy. Importantly, this work reinforces the
importance of a tailored program of prevention based on the evaluation of systemic and
local risk factors
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