Similar genotoxic factors develop osteonecrosis of the jaw (ONJ) and periodontitis in cancer patients, the etiopathogenetic link between these two diseases is controversial. The aims of this study were to investigate the impact of periodontal condition on ONJ occurrence among different cancer locations.
8,234 ONJ patients and 32,912 age- and gender-matched comparisons were collected from malignancy patients, the longitudinal health insurance database was derived from National Health Insurance of Taiwan from 2000 to 2010. The population was subdivided into groups based on different cancer location, severity of periodontitis and dental care. Chi-square test was used to test the difference of demographic characteristics and medical history between ONJ and comparison group. Multivariable logistic regression analysis performed by the SAS software version 9.4 was used to assess the association between ONJ and ONJ -associated risk factor.
The lip, oral cavity, and pharynx malignancy had the highest ONJ risk (adjusted OR, 5.45; 95% CI, 4.69–5.45) among all cancer locations. There was a positive correlation between periodontal condition and ONJ. Patients with serious periodontitis had 3.52-fold risk to develop ONJ (95% CI, 2.80–4.42) than those who had no periodontitis; patients with good dental care had lower ONJ risk than those with poor dental care (trend test P
This study revealed the close association between ONJ and different cancer locations. There is strong correlation between periodontal condition and the risk of ONJ. According to the linear relationship between severity periodontitis and ONJ, the severity of periodontitis might be regarded as the predicting target for ONJ incidence among the most of cancer patients in clinic. Poor dental care population had higher incidence of ONJ and we could speculate the good dental care might be the supreme principle to prevent the ONJ in cancer patients. That the periodontal condition and cancer location significantly impact on the risk of ONJ after the BPs used was adjusted, and highlighted the importance of dental care for preventing ONJ in cancer patients.
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This study was approved by the Institutional Review Board in China Medical University Hospital.
This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039-005), Chang Gung Memorial Hospital (CMRPG3E1341), Far Eastern Memorial Hospital (FEMH-2016-C-036), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.
All authors have declared no conflicts of interest.