Evidence map›Paper›PMID 42084648›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

Medication-related osteonecrosis of the jaw: incidence and risk factors in multiple myeloma patients undergoing pre-autologous stem cell transplant dental extractions.

Ji-Eun Deanna Son, Joo Wan James Kim, Sung-Ha Son, Matthew Kreher, Guido Lancman, David Hodgson, Sita Bhella, Vishal Kukreti, Keith Stewart, Christine I Chen and 4 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Ji-Eun Deanna SonTemerty Medicine, University of Toronto, Toronto, ON, Canada.
Joo Wan James KimDepartment of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Sung-Ha SonDepartment of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Matthew KreherDepartment of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Guido LancmanDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
David HodgsonDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Sita BhellaDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Vishal KukretiDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Keith StewartDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Christine I ChenDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Gaurav KrishnamoorthyDepartment of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Michael GlogauerDepartment of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Patricia BrooksTemerty Medicine, University of Toronto, Toronto, ON, Canada.
Erin WatsonDepartment of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada. erin.watson@uhn.ca.ORCID http://orcid.org/0000-0002-2096-7732

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this retrospective study was to investigate the incidence of MRONJ and its related risk factors in multiple myeloma (MM) patients undergoing dental extractions prior to autologous stem cell transplantation (ASCT).

methodsThis retrospective study evaluated patients treated January 1, 2011, to January 1, 2022. Medical and dental records of 1547 patients referred to the Dental Oncology Clinic at Princess Margaret Cancer Centre were reviewed, with 320 patients meeting the eligibility criteria and included in the analysis.

resultsAmong 320 patients, patients had on average 3 teeth removed prior to ASCT and 13 (4.1%) developed MRONJ. Periodontal disease was the most common reason for dental extraction among MRONJ cases. Patients prescribed zoledronic acid alone were nearly 5 times more likely to develop MRONJ than patients treated with pamidronate alone, with the highest risk observed in patients who were prescribed pamidronate and later changed to zoledronic acid. Even a single dose of bisphosphonate was sufficient to cause MRONJ following dental extraction and in some cases, onset to MRONJ following extraction was in the span of years.

conclusionThe decision to recommend extractions in patients previously exposed to intravenous bisphosphonates should take into account the severity of dental disease versus risk of MRONJ. In particular, the type and duration of bisphosphonate therapy should be considered. When extractions are performed in patients at-risk of MRONJ, they should be warned of the risk (around 4% in this study) and followed for a period appropriate to detect complications.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawBone Density Conservation AgentsMultiple MyelomaTooth ExtractionAdultAgedFemaleHumansIncidenceMaleMiddle AgedPamidronatePeriodontal DiseasesRetrospective StudiesRisk FactorsStem Cell TransplantationBone Density Conservation AgentsPamidronateZoledronic AcidAutologous stem cell transplantBone-modifying agentsDental extractionsDental oncologyMedication-related osteonecrosis of the jawMyeloma

Identifiers

PMID42084648

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