A University of Oulu study links antiresorptive drugs and dental procedures to medication-related osteonecrosis of the jaw in breast cancer patients with bone metastases.

A nationwide registry study from the University of Oulu has identified the incidence of medication-related osteonecrosis of the jaw (MRONJ) among Finnish breast cancer patients with bone metastases. The research, published in Clinical Oral Investigations, examined patients receiving antiresorptive treatments, which are used to prevent skeletal complications. The findings highlight the role of oral health management in patients undergoing these therapies.

Incidence Rates and Treatment Types

The study analyzed 652 breast cancer patients with bone metastases who received antiresorptive treatment between 2013 and 2015, with follow-up continuing through 2020. Researchers found that 12.6% of patients treated with denosumab alone developed osteonecrosis of the jaw. For patients who initially received bisphosphonates before switching to denosumab, the incidence rate was 15.3%. A smaller proportion of patients treated exclusively with bisphosphonates developed the condition.

Oral Health and Clinical Recommendations

The research identified associations between dental procedures, specifically tooth extractions and root canal treatments, and an increased risk of jawbone necrosis. However, researchers noted that the small number of patients undergoing root canal treatment means the procedure itself is not confirmed as a cause. Doctoral researcher Miika Kujanpää stated that the findings do not warrant stopping antiresorptive treatment, as the benefits and risks must be assessed individually. Instead, the study emphasizes the need for identifying and treating oral infections before therapy begins and maintaining close collaboration between oncology and dental professionals.