{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:18:34Z","timestamp":1780319914739,"version":"3.54.1"},"reference-count":45,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2006,2,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> To describe the clinical, radiologic, and pathologic features and risk factors for osteonecrosis of the jaw (ONJ) in multiple myeloma (MM) patients. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> A retrospective review of 90 MM patients who had dental assessments, including 22 patients with ONJ. There were 62 men; the median age was 61 years in ONJ patients and 58 years among the rest. Prior MM therapy included thalidomide (n = 67) and stem-cell transplantation (n = 72). Bisphosphonate therapy included zoledronate (n = 34) or pamidronate (n = 17) and pamidronate followed by zoledronate (n = 33). Twenty-seven patients had recent dental extraction, including 12 patients in the ONJ group. Median time from MM diagnosis to ONJ was 8.4 years for the whole group. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Patients usually presented with pain. ONJ occurred posterior to the cuspids (n = 20) mostly in the mandible. Debridement and sequestrectomy with primary closure were performed in 14 patients; of these, four patients had major infections and four patients had recurrent ONJ. Bone histology revealed necrosis and osteomyelitis. Microbiology showed actinomycetes (n = 7) and mixed bacteria (n = 9). More than a third of ONJ patients also suffered from long bone fractures (n = 4) and\/or avascular necrosis of the hip (n = 4). The variables predictive of developing ONJ were dental extraction (P = .009), treatment with pamidronate\/zoledronate (P = .009), longer follow-up time (P = .03), and older age at diagnosis of MM (P = .006). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> ONJ appears to be time-dependent with higher risk after long-term use of bisphosphonates in older MM patients often after dental extractions. No satisfactory therapy is currently available. Trials addressing the benefits\/risks of continuing bisphosphonate therapy are needed. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2005.04.2465","type":"journal-article","created":{"date-parts":[[2006,2,16]],"date-time":"2006-02-16T23:47:57Z","timestamp":1140133677000},"page":"945-952","source":"Crossref","is-referenced-by-count":446,"title":["Osteonecrosis of the Jaw in Multiple Myeloma Patients: Clinical Features and Risk Factors"],"prefix":"10.1200","volume":"24","author":[{"given":"Ashraf","family":"Badros","sequence":"first","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianna","family":"Weikel","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Salama","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Goloubeva","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Schneider","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Rapoport","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Fenton","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Gahres","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Sausville","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Ord","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Meiller","sequence":"additional","affiliation":[{"name":"From the University of Maryland Marlene and Stewart Greenebaum Cancer Center; University of Maryland Dental School, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.4065\/78.1.21"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2005.03.001"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcmd.2004.01.001"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.2.671"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030847"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E357"},{"key":"R7","unstructured":"Boivin G, Meunier PJ: Effects of bisphosphonates on matrix mineralization. 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