Dental News - New research could prevent jaw damage for cancer patients in need of oral surgery

Dental Tribune International

Thu. 16. May 2019

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LOS ANGELES, U.S.: To this day, there is no clinical procedure to treat or stop loss of jawbone tissue, a potentially deadly side effect that can occur after treatment with bisphosphonates. Researchers from the University of California, Los Angeles (UCLA) and the University of Southern California are trying to tackle the issue and have collaborated in a study that could potentially prevent patients treated for cancer or osteoporosis from experiencing jawbone damage as a result of oral surgery.

Currently, bisphosphonates are used to treat patients who have bone cancer or osteoporosis. These drugs bind to the skeleton for months or even years after the initial treatment and prevent bone density loss. However, in some cases, cancer patients who receive high doses of the drug during treatment experience side effects such as jaw damage or painful and chronic inflammation and infection as a result of routine oral surgery or a common oral procedure. This, in turn, can lead to the loss of jawbone tissue.

“When being treated for cancer, the infusion of the high-dose bisphosphonate drug is an important tool to control bone pain and osteolysis in patients with cancers,” said Dr. Ichiro Nishimura, Professor of Prosthodontics at the UCLA School of Dentistry and a member of the UCLA Jonsson Comprehensive Cancer Center. “These are cancers that originate in bone marrow, such as multiple myeloma, or that have metastasized to the skeleton, such as from breast and prostate cancers. The presence of this bisphosphonate represents a significant risk, particularly following needed routine dental surgery,” he concluded.

The researchers were able to remove the bisphosphonate drugs from the jawbone by injecting another kind of bisphosphonate compound that is inert and does not produce a pharmacological effect. Using the technique, they were able to displace the bisphosphonate drug bound to the jawbone’s surface in the in vivo model. The research team is hoping that the technique will allow bisphosphonate to remain bound to the remainder of the skeleton and continue to prevent bone loss while being displaced from the jawbone and clearing the way for oral surgery.

The study, titled “Rescue bisphosphonate treatment of alveolar bone improves extraction socket healing and reduces osteonecrosis in zoledronate-treated mice,” was published in the June 2019 issue of Bone.

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