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Topic: Zometa and Osteonecrosis

Forum: Bone Health and Bone Loss —

Talk with others about bone density, osteopenia and osteoporosis, and ways to keep your bones strong

Posted on: Mar 19, 2021 01:47PM

spicedlife wrote:

Hi all,

I really need help concerning some dental work I need. I have to get a couple of teeth (or what's left of them ) extracted. My bridge won't stay in my mouth because there is just nothing there to hold it in place anymore. I need to get an implant or a partial to replace the teeth. Problem is that I have bone mets and am getting Zometa infusions monthly since January 2018. I know dental work needed to be done prior to starting Zometa but I didn't need it then.

Can anyone point me to the right thread or tell me their experiences?

Thanks so much.....Jenny PS You know, I didn't know I would give up so much of my life....teeth, walking/jogging, I'll stop now. Sorry, I'm feeling sorry for myself.



Surgery 3/5/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel Surgery 4/16/2012 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Chemotherapy 6/4/2012 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 10/8/2012 Femara (letrozole) Surgery 11/5/2012 Reconstruction (left): DIEP flap, Nipple reconstruction; Reconstruction (right): DIEP flap, Nipple reconstruction Surgery 3/16/2013 Reconstruction (left): DIEP flap, Nipple reconstruction; Reconstruction (right): DIEP flap, Nipple reconstruction Dx 11/30/2017, IDC, Stage IV, metastasized to bone, Grade 2, 1/15 nodes, ER+/PR+, HER2- (FISH)
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Mar 20, 2021 07:52AM Rah2464 wrote:

Spicedlife I would highly recommend that you meet with your regular dentist, and then a specialist to discuss how to approach a potential tooth extraction while on Zometa monthly. I know that a lot of dental surgeons would want a period of no infusion activity before attempting extraction in order to reduce the risk of osteonecrosis. This may require a coordinated effort between your MO and your dental surgeon in order to provide you the most successful outcome.

I was researching this a lot because I had a tooth that needed work and I am due to start Reclast (which is a lower dosing regimen for osteoporosis) . My dental surgeon said he could do extractions safely three months after an infusion if need be. However, reclast taken every six months is obviously not the same dosing level as Zometa taken monthly. You will need to find a professional to help you set up a plan of attack. So very very sorry you have this worry on top of everything else. These drugs just do a number on us don't they? Hugs

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/26/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 21, 2021 08:57PM spicedlife wrote:

Cancer is truly the "gift that just keeps on"

Hugs to you Rah.

Surgery 3/5/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel Surgery 4/16/2012 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Chemotherapy 6/4/2012 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 10/8/2012 Femara (letrozole) Surgery 11/5/2012 Reconstruction (left): DIEP flap, Nipple reconstruction; Reconstruction (right): DIEP flap, Nipple reconstruction Surgery 3/16/2013 Reconstruction (left): DIEP flap, Nipple reconstruction; Reconstruction (right): DIEP flap, Nipple reconstruction Dx 11/30/2017, IDC, Stage IV, metastasized to bone, Grade 2, 1/15 nodes, ER+/PR+, HER2- (FISH)
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Mar 21, 2021 09:20PM - edited Mar 21, 2021 11:01PM by Olma61

hi there, I was on Xgeva for bone Mets which has the same risk of osteonecrosis as zometa.

I lost a crown in the front of my mouth which required an extraction and I wanted an implant

I had been on Xgeva approx two years at that time. The surgeon wanted me to be off Xgeva for six months before and six months after the procedure. My MO had also said, at least three months.

I wound up starting the work a little before the six months was up and I haven't gone back on Xgeva because I need more work done. My implant in the front is finished and it all worked out fine, no problems. So far, no osteonecrosis.

I never had any fractures or anything from my Mets and I've been NED for awhile, so I am okay with taking a long break from Xgeva. My doctor wants me to go back on but I want my teeth fixed more than I want to go back on Xgeva.

I had lost a bridge in the back at the start of chemo and couldn't have that fixed so I am trying to play catch up now.

If your doctor okays it and you feel brave enough..you might want to go for it. I am not Pooh-poohing the risks involved but women who don't get dental work can als wind up with ONJ, so...the risk is still present as long as we are on the drugs.



10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/30/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/30/2019 External: Bone
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Mar 22, 2021 10:53PM mirryp wrote:

I have bi phosphate caused onj. It is beyond miserable. I have had 4 surgeries and am scheduled for a 5th. It isn't just my jaw either, it spread to sinus bones and orbital bone causing my eye to protude. I have lost several teeth. Sorry, you didn't need all that probably but I did feel the need to seriously caution proceeding carefully. Look for an oral surgeon that specializes in onj to do any work. I was told this morning that zometa has a half life of 10 years. It will definitely be a weigh the risk decision. If your teeth and gums are in good shape the risk will be less. I wish you well.

Dx 6/8/2011, IDC, Left, 5cm, Stage IV, metastasized to bone/lungs, Grade 2, 4/4 nodes, mets, ER+/PR+, HER2- (DUAL) Chemotherapy 6/20/2011 Ixempra (ixabepilone) Hormonal Therapy 9/19/2012 Femara (letrozole) Hormonal Therapy 7/4/2016 Arimidex (anastrozole) Surgery 8/11/2019 Mastectomy: Right
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Mar 25, 2021 12:13PM spicedlife wrote:

Dearest sister!

Thank you so much for sharing about your health. I am so sorry and dismayed for you.

I'll see the oral surgeon to see what can be done but you pretty much helped me make my decision.

My Oncologist pretty much said the nightmares are exactly what you're having.


I was diagnosed in 2012 by the way and Mets came in 2017.


Love and prayers right now, Jenny

Surgery 3/5/2012 Lumpectomy: Right; Lymph node removal: Right, Sentinel Surgery 4/16/2012 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Chemotherapy 6/4/2012 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 10/8/2012 Femara (letrozole) Surgery 11/5/2012 Reconstruction (left): DIEP flap, Nipple reconstruction; Reconstruction (right): DIEP flap, Nipple reconstruction Surgery 3/16/2013 Reconstruction (left): DIEP flap, Nipple reconstruction; Reconstruction (right): DIEP flap, Nipple reconstruction Dx 11/30/2017, IDC, Stage IV, metastasized to bone, Grade 2, 1/15 nodes, ER+/PR+, HER2- (FISH)
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Mar 25, 2021 06:47PM Olma61 wrote:

Mirryp, so sorry for what you are going through with this awful disease. Hoping ongoing treatment helps bring you relief.

Regarding the length of time zometa stays in the body, it seems Xgeva is believed to be eliminated more quickly, so that’s an important consideration, thank you for bringing that up,

Found this article which mentions this and other considerations -

https://www.curetoday.com/view/watch-your-mouth

Sincere wishes for good outcomes for all of us


Heart


10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+ (IHC) Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/30/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/30/2019 External: Bone

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