I was on Zometa for a few years and, while on it, I had to have a tooth extracted. I do not remember the name of the procedure the oral surgeon performed, but essentially it involved drawing blood prior to the pull, the blood was spun in a special machine, then just the plasma (I think) was put into the cavity where the tooth was, then it was stitched closed. It healed beautifully.
Best of luck!
Forums
Re: Aredia & osteonecrosis of the jaw - what to do?
You may want to review the most recent position statement of the American Association of Oral and Maxillofacial Surgeons on medication-related osteonecrosis of the jaw. It has all you want to know about the condition and its treatment.
SL Ruggiero et al, "American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw – 2014 Update," Journal of Oral and Maxillofacial Surgery, October 2014 (link to full text article)
SL Ruggiero et al, "American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw – 2014 Update," Journal of Oral and Maxillofacial Surgery, October 2014 (link to full text article)
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goldmine848 - Name: Andrew
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 60
Re: Aredia & osteonecrosis of the jaw - what to do?
Joannet,
Your procedure with the injected plasma cells sounds like a "Platelet Rich Plasma" (PRP) procedure. I once had PRP done when I had torn my achilles tendon (major ouch) and had to get it rebuilt. My doc strongly suggested I do a PRP procedure to accelerate the healing after surgery. Insurance didn't cover the PRP procedure, but I gladly paid for it and would do so again since I healed incredibly fast.
For use of PRP in ONJ, note:
S Bocanegra-Perez et al, "Use of platelet-rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw," International Journal of Oral & Maxillofacial Surgery, 2012 (link to abstract)
F Longo et al, "Platelet Rich Plasma in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw: Personal Experience and Review of the Literature," International Journal of Dentistry, 2014 (link to full text article)
Your procedure with the injected plasma cells sounds like a "Platelet Rich Plasma" (PRP) procedure. I once had PRP done when I had torn my achilles tendon (major ouch) and had to get it rebuilt. My doc strongly suggested I do a PRP procedure to accelerate the healing after surgery. Insurance didn't cover the PRP procedure, but I gladly paid for it and would do so again since I healed incredibly fast.
For use of PRP in ONJ, note:
S Bocanegra-Perez et al, "Use of platelet-rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw," International Journal of Oral & Maxillofacial Surgery, 2012 (link to abstract)
F Longo et al, "Platelet Rich Plasma in the Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw: Personal Experience and Review of the Literature," International Journal of Dentistry, 2014 (link to full text article)
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Aredia & osteonecrosis of the jaw - what to do?
Joannet,
I had never heard of that procedure your oral surgeon performed. That is a great tip and thanks for contributing it to this forum. I will certainly be remembering it should I need any work done and will seek an oral surgeon who is familiar with it. It would be good if information like this could be put in some kind of "what you need to know when living with myeloma 101" course that could be easily referenced. If you have any specifics on what the procedure specifically is and who does it, that would be helpful. It seems to be closely related to what MultiBilly posted, but done as a preventative measure for tooth extraction.
I see an oral surgeon pulled your tooth and not a dentist. I have nothing against dentists – I have a really good one who is a friend. A normal tooth extraction would normally be done by a dentist. But I am pretty sure mine does not have the capability to draw blood and does not have the special machine you described to spin it. If I need to have a tooth extracted, I will be working with my dentist to find an oral surgeon.
It frustrates me that Johanna and her husband did not seem to be aware of the risk and procedures like the one you mentioned before he had his tooth pulled. I hope all goes well for them.
I had never heard of that procedure your oral surgeon performed. That is a great tip and thanks for contributing it to this forum. I will certainly be remembering it should I need any work done and will seek an oral surgeon who is familiar with it. It would be good if information like this could be put in some kind of "what you need to know when living with myeloma 101" course that could be easily referenced. If you have any specifics on what the procedure specifically is and who does it, that would be helpful. It seems to be closely related to what MultiBilly posted, but done as a preventative measure for tooth extraction.
I see an oral surgeon pulled your tooth and not a dentist. I have nothing against dentists – I have a really good one who is a friend. A normal tooth extraction would normally be done by a dentist. But I am pretty sure mine does not have the capability to draw blood and does not have the special machine you described to spin it. If I need to have a tooth extracted, I will be working with my dentist to find an oral surgeon.
It frustrates me that Johanna and her husband did not seem to be aware of the risk and procedures like the one you mentioned before he had his tooth pulled. I hope all goes well for them.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Aredia & osteonecrosis of the jaw - what to do?
Thank you all for the great responses.
The PRP idea looks very promising and interesting. I would definitely make a few inquiries with the oncologist and some specialists in Scotland.
Multibilly, I would like to ask who did this procedure? Was it a specialized surgeon / dentist?
I have a hard time trying to find anything like it in Scotland or across the UK. I keep getting face lift clinics and surely it doesn't sound like the specialist I want Ian to see (they do lip fillings for females)
We could probably afford it (not sure yet), so it can be done privately if not through the oncologist. I'm just wondering if it can be done now, as this tooth extraction was done at least 6 months ago.
Thank again guys.
Joanna & Ian
The PRP idea looks very promising and interesting. I would definitely make a few inquiries with the oncologist and some specialists in Scotland.
Multibilly, I would like to ask who did this procedure? Was it a specialized surgeon / dentist?
I have a hard time trying to find anything like it in Scotland or across the UK. I keep getting face lift clinics and surely it doesn't sound like the specialist I want Ian to see (they do lip fillings for females)
We could probably afford it (not sure yet), so it can be done privately if not through the oncologist. I'm just wondering if it can be done now, as this tooth extraction was done at least 6 months ago.
Thank again guys.
Joanna & Ian
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johanna - Name: Joanna
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: august 2012
- Age at diagnosis: 60
Re: Aredia & osteonecrosis of the jaw - what to do?
Joanna,
Have you talked to Ian's oncologist yet and notified him/her of the issue and asked for advice on what to do and who to see about this problem?
I think doing anything else before you've taken that step is, as they say, putting the cart before the horse.
Have you talked to Ian's oncologist yet and notified him/her of the issue and asked for advice on what to do and who to see about this problem?
I think doing anything else before you've taken that step is, as they say, putting the cart before the horse.
Re: Aredia & osteonecrosis of the jaw - what to do?
Hi Johanna,
To answer your question about who did my PRP, first, be clear that this was for an Achilles tendon surgery, not a dental procedure. My doctor, who diagnosed the problem suggested the PRP procedure and also did the surgery, was a brilliant podiatrist.
I also have no idea how commonplace the use of PRP is in oral surgery circles. We are really talking apples and oranges when comparing an Achilles tendon surgery to an ONJ treatment.
To answer your question about who did my PRP, first, be clear that this was for an Achilles tendon surgery, not a dental procedure. My doctor, who diagnosed the problem suggested the PRP procedure and also did the surgery, was a brilliant podiatrist.
I also have no idea how commonplace the use of PRP is in oral surgery circles. We are really talking apples and oranges when comparing an Achilles tendon surgery to an ONJ treatment.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Aredia & osteonecrosis of the jaw - what to do?
The links MultiBilly posted were for the use of PRP to treat ONJ and I was referring to that being closely related and not the procedure he had done on his ankle. It is encouraging, though, that the procedure did work on the ankle and is an example of it being used.
I have no idea how common PRP is used in oral surgery, either, but the articles are only a few years old, so maybe this is not something that has been around that long.
I see using PRP to treat ONJ, and using PRP as a preventative measure for a tooth extraction to reduce the risk of developing ONJ, to be pretty closely related. I would think an oral surgeon who can treat ONJ with PRP would be able to use it for tooth extraction in a patient at high risk for developing PRP.
Another question that comes to my mind is, if ONJ develops, I would think the treatment cost would be covered by medical insurance and not dental insurance. I will have to ask my HMO about this. Most dental insurance in the US is not that good.
I have no idea how common PRP is used in oral surgery, either, but the articles are only a few years old, so maybe this is not something that has been around that long.
I see using PRP to treat ONJ, and using PRP as a preventative measure for a tooth extraction to reduce the risk of developing ONJ, to be pretty closely related. I would think an oral surgeon who can treat ONJ with PRP would be able to use it for tooth extraction in a patient at high risk for developing PRP.
Another question that comes to my mind is, if ONJ develops, I would think the treatment cost would be covered by medical insurance and not dental insurance. I will have to ask my HMO about this. Most dental insurance in the US is not that good.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Aredia & osteonecrosis of the jaw - what to do?
Multibilly, I am glad the procedure worked on your Achilles tendon.
I just assume the skills can be extrapolated and used in other medical conditions like ONJ. I have read a few articles where the PRP procedure was done on such people with very encouraging results, they say. So we are looking forward to hear what the oncologist has to say about this.
We also ordered chlorhexideine of 0.12% strength mouthwash.
All the websites, including the American Association of Oral and Maxillofacial Surgeons, recommend this in people with ONJ that are above stage 0 (basically no bone lesions, asymptomatic, so on). It's recommended in all the other stages : 1,2 & 3. So we hope this would help as well to kill off any bacteria that is casing further damage.
Getting ready for the eclipse now and pray for good weather ))
Thanks guys,
johanna
I just assume the skills can be extrapolated and used in other medical conditions like ONJ. I have read a few articles where the PRP procedure was done on such people with very encouraging results, they say. So we are looking forward to hear what the oncologist has to say about this.
We also ordered chlorhexideine of 0.12% strength mouthwash.
All the websites, including the American Association of Oral and Maxillofacial Surgeons, recommend this in people with ONJ that are above stage 0 (basically no bone lesions, asymptomatic, so on). It's recommended in all the other stages : 1,2 & 3. So we hope this would help as well to kill off any bacteria that is casing further damage.
Getting ready for the eclipse now and pray for good weather ))
Thanks guys,
johanna
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johanna - Name: Joanna
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: august 2012
- Age at diagnosis: 60
Re: Aredia & osteonecrosis of the jaw - what to do?
Eric-
It is my understanding that an oral surgeon is covered by medical insurance. S/he does surgical procedures that are medical procedures, not dental procedures.
It would be nice if we had a guide about what things to be aware of, careful about, and when and to whom to report problems. Sometimes it is difficult to decide when to call on the oncologist and when to call on the primary doctor about issues that come up. I know that sometimes I can't determine whether a pain that is severe and lasts a long time is bone pain or muscle pain or both. If I have an appointment with my oncologist coming within a week, then I wait and report it to him. If I don't, then I am in a quandary as to who to call. For me, it has turned out to be bone pain 50% of the time and not bone pain 50% of the time.
I feel fortunate that I have a dentist who is on top of things. Recently, I had severe tooth pain and had an emergency visit with my dentist. He identified that I needed a root canal done. It was in a tooth that had a crown because, in the past, I had had so many restorations that there wasn't enough tooth left to fill any more. When I voiced my concern over the tooth because of my Zometa use, he said that the tooth would be saved and, if it couldn't be saved, that he would refer me to an oral surgeon who was experienced in treating people at high risk for ONJ. The endodontist that my dentist referred me to for the root canal procedure assured me of the same thing. I already knew that my oncologist would refer me to an oral surgeon who they deal with on a regular basis. So, I felt so much safer in the hands of the people who are treating my teeth.
Nancy in Phila
It is my understanding that an oral surgeon is covered by medical insurance. S/he does surgical procedures that are medical procedures, not dental procedures.
It would be nice if we had a guide about what things to be aware of, careful about, and when and to whom to report problems. Sometimes it is difficult to decide when to call on the oncologist and when to call on the primary doctor about issues that come up. I know that sometimes I can't determine whether a pain that is severe and lasts a long time is bone pain or muscle pain or both. If I have an appointment with my oncologist coming within a week, then I wait and report it to him. If I don't, then I am in a quandary as to who to call. For me, it has turned out to be bone pain 50% of the time and not bone pain 50% of the time.
I feel fortunate that I have a dentist who is on top of things. Recently, I had severe tooth pain and had an emergency visit with my dentist. He identified that I needed a root canal done. It was in a tooth that had a crown because, in the past, I had had so many restorations that there wasn't enough tooth left to fill any more. When I voiced my concern over the tooth because of my Zometa use, he said that the tooth would be saved and, if it couldn't be saved, that he would refer me to an oral surgeon who was experienced in treating people at high risk for ONJ. The endodontist that my dentist referred me to for the root canal procedure assured me of the same thing. I already knew that my oncologist would refer me to an oral surgeon who they deal with on a regular basis. So, I felt so much safer in the hands of the people who are treating my teeth.
Nancy in Phila
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
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