[Pjorg45]

Bone spurs and osteonecrosis of the jaw (ONJ)

by Pjorg45 on Mon Jul 20, 2015 8:57 am

I have been on monthly Zometa for two years and recently have had two teeth extracted. The teeth extraction has healed well and I feel great. But, I also have a small bone spur which grows out of my gum where my one tooth has been extracted. Other people here have reported similar small bone spurs (oral osteophytes) . My oral surgeon does not believe this is a sign of osteonecrosis of the jaw (ONJ).

My questions first question is: Who out there has experienced similar bone spurs, and if you had them, did you go on to have ONJ?

My second question is: Who out there has ONJ and what were the first symptoms and how long from the first symptoms to it became really bad?

Thanks,

Paul Jorgensen

[proudlion]

Re: Bone spurs and osteonecrosis of the jaw (ONJ)

by proudlion on Mon Jul 20, 2015 7:22 pm

Hello Paul,

My response may not be helpful but I would like to contribute my experience. I am in need of major dental work and am also receiving Zometa on a monthly basis. My oncologist forbids me from seeking any dental work without curtailing the Zometa treatments for at least eight weeks prior to the dental procedure. I am surprised that you have been permitted to obtain dental work while receiving these treatments.

The best to you,

Jerry

[Pjorg45]

Re: Bone spurs and osteonecrosis of the jaw (ONJ)

by Pjorg45 on Mon Jul 20, 2015 9:17 pm

Well I was told that I should suspend Zometta two months before and two months after the extraction. This is what I have done and I have not started Zometta again yet. In order to get a ASCT I needed dental clearance which I couldn't get without getting rid of two teeth which had bad root canels. I had no other choice.

[Jonah]

Re: Bone spurs and osteonecrosis of the jaw (ONJ)

by Jonah on Mon Jul 20, 2015 9:47 pm

Hi Paul,

I'm guessing you've seen Andrew Gordon's column from a month or two on a very similar subject. But, just in case you haven't, I think you should read it (and the comments that people made on it):

https://myelomabeacon.org/headline/2015/05/31/myeloma-lessons-this-was-a-real-surprise/

Hope the spurs turn out to be just that -- spurs, not ONJ.

[jrbpse]

Re: Bone spurs and osteonecrosis of the jaw (ONJ)

by jrbpse on Wed Jul 22, 2015 9:50 pm

The bone spurs are not part of the jaw bone problems found in multiple myeloma, but that's simply because of the ONJ. Bone spurs are probably a result of the medication since it is designed to modify the bone growth cycle.

I discontinued my use of these type products because I considered the risk to out weigh the benefits.

[Rneb]

Re: Bone spurs and osteonecrosis of the jaw (ONJ)

by Rneb on Wed Jul 22, 2015 10:06 pm

I would suggest that you confirm that you are dealing with a true "Bone Spur", as opposed to a residual tooth fragment, or a spicule of bone, loosened and de-vitalized, via the extraction process. Teeth with Bad "Root canals" , tend to come out in pieces and splinters.

Big difference between a "Bone Spur" and a perceived "foreign body" in the mandible /Maxilla. Bone spurs usually don't cause infection(s); usually they only cause local inflammation/ irritations.

Tooth fragments and Bone spicules do tend to cause secondary changes, including granualomas and frank infections/ abscesses.

This is irrespective of Zometa.

Even in the best of hands, extractions can and do, cause the above.

Good luck.

PS--Where is Coach Hoke, when you need him ?

[coachhoke]

Re: Bone spurs and osteonecrosis of the jaw (ONJ)

by coachhoke on Wed Jul 22, 2015 11:51 pm

Rneb is probably right; it is either a bone spicule or a tooth fragment that will most likely work itself loose, similar to losing a baby tooth. (I saw hundreds of these when I was still practicing dentistry).

Secondly, ONJ is very difficult to diagnose at early stages as there are no symptoms. The only way I know to make the diagnosis is from x-rays, which I assume the oral surgeon would have taken before doing the extractions.

Coach Hoke