{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:25:35Z","timestamp":1791588335796,"version":"4.3.4"},"reference-count":55,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T00:00:00Z","timestamp":1480550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Bisphosphonates (BPs) are administered to Multiple Myeloma (MM) patients with bone lytic lesion. Osteonecrosis of the Jaw (ONJ) is a complication reported since 2003  in patients treated with intravenous (IV) BPs such as zoledronic acid and pamidronate, with 6%\u201326.3% frequency in early literature series, before some preventive measures were recommended. We evaluated the occurrence of ONJ with and without dental preventive measures in MM patients treated with BPs in our centre between 1996 and 2015. Since 2005,  MM patients (already under treatment or before treatment) underwent a baseline mouth assessment (dental visit, Rx orthopantomography, and eventual tooth avulsion or dental care if necessary) and were followed by a multidisciplinary team. We reviewed the charts of 119 MM patients receiving IV BPs, classified into 3 groups: (a) \u201chistoric group\u201d (21 patients who had started BP treatment in years before the awareness of ONJ); (b) \u201cscreening group\u201d (20 patients starting BPs without baseline evaluation); and (c) \u201cprevention group\u201d (78 patients starting therapy only after baseline preventive assessment and eventual dental care measures). ONJ was observed in 3\/21 patients (14.2%) from group a, in 2\/20 patients (10%) from group b, and in no patients from group c (0%). Notably, the median number of IV BP administrations decreased after 2005. Our data confirmed a meaningful reduction of ONJ risk in MM patients treated with BPs if preventive measures are applied. Both implementation of prevention measures and reduction of cumulative doses of IV BPs could have contributed to a decreased incidence of ONJ.<\/jats:p>","DOI":"10.3390\/dj4040045","type":"journal-article","created":{"date-parts":[[2016,12,2]],"date-time":"2016-12-02T10:36:37Z","timestamp":1480674997000},"page":"45","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures"],"prefix":"10.3390","volume":"4","author":[{"given":"Gioacchino","family":"Catania","sequence":"first","affiliation":[{"name":"Haematology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Monaco","sequence":"additional","affiliation":[{"name":"Haematology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Limberti","sequence":"additional","affiliation":[{"name":"Haematology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Alessio","sequence":"additional","affiliation":[{"name":"Oncology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"},{"name":"Centro Documentazione Osteonecrosi, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iolanda","family":"De Martino","sequence":"additional","affiliation":[{"name":"Oncology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"},{"name":"Centro Documentazione Osteonecrosi, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Barile","sequence":"additional","affiliation":[{"name":"Centro Documentazione Osteonecrosi, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Fasciolo","sequence":"additional","affiliation":[{"name":"Maxillofacial Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Baraldi","sequence":"additional","affiliation":[{"name":"Haematology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ladetto","sequence":"additional","affiliation":[{"name":"Haematology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Fusco","sequence":"additional","affiliation":[{"name":"Oncology Unit, Alessandria Hospital, 15121 Alessandria AL, Italy"},{"name":"Centro Documentazione Osteonecrosi, Alessandria Hospital, 15121 Alessandria AL, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/leu.2008.291","article-title":"Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma","volume":"23","author":"Kyle","year":"2009","journal-title":"Leukemia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3205","DOI":"10.1182\/blood-2011-06-297853","article-title":"Approach to the treatment of multiple myeloma: A clash of philosophies","volume":"118","author":"Rajkumar","year":"2011","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2464","DOI":"10.1200\/JCO.2007.12.1269","article-title":"American Society of Clinical Oncology 2007 clinical practice guideline update on the role of bisphosphonates in multiple myeloma","volume":"25","author":"Kyle","year":"2007","journal-title":"J. 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