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Old 02-08-2009, 10:50 AM   #1
Vic
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Join Date: Aug 2007
Location: Newport Beach, CA
Posts: 161
Post My dentist suggested I contact this researcher before using Zometa

Here's an article on a dental research from University of So. Cal. (USC) whom my dentist wanted me to contact before using Zometa. The "half-life" issue does concern me. Any problems with some of you out there? Realistically, it seems that many of you have been just fine, and I'm going to write Dr. Sedghizadeh and ask him if the safety factor is reduced once infusions stop or if there is a lingering concern, which seems to be the focus of this article. I pasted this in case some of you didn't want to click on the link, but if you prefer a better format, the link is included here.

Vicki


http://www.usc.edu/hsc/dental/update...hNecrosis.html



SCHOOL OF DENTISTRY CLINIC DATA LINKS ORAL BISPHOSPHONATES TO INCREASED JAW NECROSIS RISK
USCSD study is among the first to acknowledge correlation between the common medications and jawbone death.

1/01/09
By Beth Dunham
Even short-term use of common oral osteoporosis drugs may leave the jaw vulnerable to devastating necrosis, according to a new USC School of Dentistry study appearing in the January 1 Journal of the American Dental Association (JADA).
“Oral Bisphosphonate Use and the Prevalence of Osteonecrosis of the Jaw: An Institutional Inquiry” is the first large institutional study in the U.S. to investigate the relationship between oral bisphosphonate use and jaw bone death, said principal investigator Parish Sedghizadeh, assistant professor of clinical dentistry with the USC School of Dentistry.
After controlling for referral bias and other patient health factors, nine of 208 School of Dentistry patients who take or have taken Fosamax for any length of time were diagnosed with osteonecrosis of the jaw (ONJ). The study’s results are in contrast to drug makers’ prior assertions that bisphosphonate-related ONJ risk is only noticeable with intravenous use of the drugs, not oral usage, Sedghizadeh said.
“We’ve been told that the risk with oral bisphosphonates is negligible, but four percent is not negligible,” he said.
Most doctors who have prescribed bisphosphonates have not told patients about any oral health risks associated with the use of the drugs, despite even short-term usage posing a risk due to the drug’s tenacious 10-year half-life in bone tissue. Lydia Macwilliams of Los Angeles said no one told her about the risk posed by her three years of Fosamax usage until she became a patient of Sedghizadeh at the School of Dentistry.
“I was surprised,” she said. “My doctor who prescribed the Fosamax didn’t tell me about any possible problems with my teeth.”
Macwilliams was especially at risk for complications because she was to have three teeth extracted. The infection is a biofilm bacterial process, meaning that the bacteria infecting the mouth and jaw tissues reside within a slimy matrix that protects the bacteria from many conventional antibiotic treatments, and bisphosphonate use may make the infection more aggressive in adhering to the jaw, Sedghizadeh said. The danger is especially pronounced with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.
After her extractions, two of the three extraction sites had difficulty healing due to infection, Macwilliams said. Luckily, with treatment as well as the rigorous oral hygiene regimen that USC dentists developed especially for patients with a history of bisphosphonate usage, the remaining sites slowly but fully healed.
“It took about a year to heal,” she said, “but it’s doing just fine now.”
Sedghizadeh hopes to have other researchers confirm his findings and thus encourage more doctors and dentists to talk with patients about the oral health risks associated with the widely used drugs. The results confirm the suspicions of many in the oral health field, he said.
“Here at the School of Dentistry, we’re getting two or three new patients a week that have bisphosphonate-related ONJ,” he said, “and I know we’re not the only ones seeing it.”
__________________
Diagnosed 12/03 at age 53
1.5cm tumor, ER-PR-, Her2 3+(rt side)
Stage 1B, Three negative nodes from Sentinel Node Biopsy
Paget's of the nipple, Infiltrating Ductal Carcinoma and DCIS of the rt breast
Bloom-Richardson score 8/9, P53+ 60-70%, Ki-67+ 30-40%
Skin-sparing mastectomy with immediate lat-flap reconstruction and saline implants, 1/04
Chemo: FAC, five sessions every three weeks Feb.-May 04, then switched to HTC weekly for 12 weeks, June-Aug 04
Zometa every 6 months for osteopenia, started April 09
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