Dental Outcomes of Osteonecrosis of the Jaw (ONJ).

e19675 Background: The optimal treatment and expected dental outcome of osteonecrosis of the jaw (ONJ) is not well understood. Dental management is recommended and administered as per a standard guideline at our institution, which has not changed over time. However, baseline dental screening and the increased awareness of ONJ may contribute to earlier diagnosis and improved dental outcomes. Methods: We performed a retrospective analysis of ONJ patients diagnosed at our institution between 6/2001- 6/2010. Patient characteristics, manifestations of ONJ, stage at presentation, dental treatments, and dental response were stratified by year of diagnosis. Results: We identified 56 ONJ patients with a median age of 58.5 years (40-82) who were diagnosed with breast cancer (63%), myeloma (30%), and 4 other cancers (7%). All patients received IV bisphosphonate (BP), zolendronate (78%), pamidronate (13%), or both (9%). Additional patient characteristics will be reported. ONJ characteristics, sites, and stage at presentation are recorded in the table. Median duration and dose of BP before ONJ diagnosis were 27.9 months (2.9-100.4), and 29.5 doses (4-100). Dental treatment and outcome are recorded in the table. Conclusions: Although the treatment for ONJ and the stage of presentation has not changed over time, the CR rate has improved at Roswell Park Cancer Institute. ONJ presentation, treatments, and response. Results (%) All ≤2006 2007-2010 n = 56 n = 28 n = 28 Necrotic bone 50 (89) 24 (86) 26 (93) Purulence 26 (46) 11 (39) 15 (54) Swelling 20 (36) 9 (32) 11 (39) Pain 33 (59) 14 (50) 19 (68) Paresthesia 9 (16) 5 (18) 4 (14) Tooth mobility 13 (23) 4 (14) 9 (32) Edentulous 6 (11) 3 (11) 3 (11) Sites of ONJ Maxilla only 14 (25) 9 (32) 5 (18) Mandible only 32 (57) 13 (46) 19 (68) Both 10 (18) 6 (22) 4 (14) Stages 0 5 (9) 3 (11) 2 (7) 1 19 (34) 10 (36) 9 (32) 2 30 (54) 14 (50) 16 (57) 3 2 (4) 1 (4) 1 (4) Treatments Antibiotics 46 (82) 23 (82) 23 (82) Alveoplasty/debridement 37 (66) 17 (61) 20 (71) Chlorhexidine scrub 49 (88) 23 (82) 26 (93) Alvogyl/dressing 7 (13) 3 (11) 4 (14) Denture adjustment 6 (11) 5 (18) 1 (4) Dental response Complete resolution 18 (38) 7 (30) 11 (42) Partial resolution 11 (22) 7 (30) 4 (15) Stable disease 13 (26) 5 (22) 8 (31) Progressive disease 7 (14) 4 (18) 3 (12) Missing 7 5 2