[spreiserowicz]

Skipping quarterly Zometa to get a dental implant

by spreiserowicz on Wed Jun 15, 2016 12:12 pm

I'm 9 months into treatment with Velcade, Revlimid, and dexamethasone (VRD) and have total remission thus far. I chose with approval of doctor not to do transplant because of positive results to date. I am also on a quarterly regimen of Zometa; my next treatment is end of June. To date I have shown no bone issues. A PET/CT scan that was done before my treatments came out completely normal and have had no issues since.

I visited my dentist the other day for a dental implant and was told I need my myeloma doctor to give his approval. Apparently, on rare occasions, necrosis of the jaw can occur. The recom­mendation is to do the implant 3 months after the last Zometa treatment and 3 months before the next one. Since I get it every 3 months, I would have to skip one treatment.

Does anyone have any insight into these issues and if skipping a treatment is okay?

Thanks in advance.

[cdnirene]

Re: Skipping quarterly Zometa to get a dental implant

by cdnirene on Wed Jun 15, 2016 2:30 pm

I was diagnosed in September 2014, no measurable M-spike by December, and finished treatment the following June. No maintenance.

I only started monthly Zometa treatments three weeks after that, and then only because I complained of some minor shoulder pain, which has since mostly disappeared.

[Ellen Harris]

Re: Skipping quarterly Zometa to get a dental implant

by Ellen Harris on Wed Jun 15, 2016 8:33 pm

You have to check with your doc, but I think skipping a treatment is OK. I received implants in December, and just now started Zometa, although I had not been on Zometa before due to kidney issues. I would think that unless you have severe osteoperosis or bony disease from the myeloma, it would be OK to skip, especially since you are in CR.

Hope the implants go well! Mine were a lot less painful than I expected them to be. The extractions I had to have preceding the implants were much more painful. The pain in the wallet, however, was intractable!

Good luck!

Ellen Harris

[Phw]

Re: Skipping quarterly Zometa to get a dental implant

by Phw on Thu Aug 11, 2016 8:45 pm

Hello my friend,

I was told that having implants done after being on Zometa for any length of time was completely out of the question. Needless to say, I was angry and disappointed as I was in need of extensive dental work. I then contacted several specialists in dentistry who were familiar with multiple myeloma and Zometa and after much research came to the conclusion that my oncologist was correct. The risk for osteonecrosis of the jaw (ONJ) was far too great .

I am now resigned to the fact that dentures are my only safe option. Skipping one cycle won't make a difference. Zometa has a "half life" of 11 years (or so I was told by several experts).

Good luck. Regards Ph

[moonscape]

Re: Skipping quarterly Zometa to get a dental implant

by moonscape on Sat Aug 13, 2016 12:49 am

This has been a thorny issue for me. I wanted to get an implant, and had not even started Zometa. But due to the time required, and other dental work I needed to get behind me before beginning Zometa, I opted for a bridge.

Personally, I wouldn't consider an implant after having had Zometa, but I run on the paranoid side about osteonecrosis of the jaw (ONJ). It's very unpredictable. The odds of getting it aren't huge (less than 10% if I recall correctly), but increase significantly once one exposes bone. Some dental surgeons don't agree with the 3-month window and say it should be a year, but in all my querying (oncologists, dental surgeon, dentist, endodontist), there was nothing definitive that guided me except erring on the side of caution.

[torimooney]

Re: Skipping quarterly Zometa to get a dental implant

by torimooney on Wed Aug 17, 2016 1:24 pm

My multiple myeloma specialist says wait 6 weeks after the last Zometa infusion before having invasive dental work (implants and extractions), and resume Zometa 6 weeks after the invasive dental work.