Page 36 - GP Fall Final 2017

ment of bone, gingival inflammation, red- parathyroid hormone, and medical ozone James R. Keenan, DDS,
ness, and ulceration may precede the clin- applied topically, there is limited data to
ical presentation of MRONJ. The clinical support the benefit of any as a standard MS, MAGD, LLSR is a
manifestations may appear spontaneously treatment approach presently. 12 graduate of NYU College
or appear subsequently to an oral surgical of Dentistry and completed
procedure. Occasionally, patients who have Additionally, there is no reliable data to a GPR at Peninsula Hospi-
maxillary bone involvement present with establish any conclusive benefit to the dis- tal Center in Arverne, NY.
chronic maxillary sinusitis. MRONJ is ob- continuation of or a “drug holiday” of the He is an Assistant Clinical
served twice as often in the mandible than antiresorptive or antiangiogenic therapy in Professor at NYU College of Dentistry
the maxilla; however, it may appear in both patients with MRONJ. Discontinuation may in the Department of Oral Maxillofa-
arches. stabilize the sites of necrosis, reduce the risk cial Pathology, Radiology and Medicine
of further development, and alleviate symp- in the Special Care Dentistry clinic and
While MRONJ can be visualized on pan- toms, however, there is the risk of recur- a mentor in the Integrated Basic Sci-
oramic, CBCT, CT, or MRI, its radio- rent osseous pain, an increase in SREs, and ence Seminars. Additionally, he main-
graphic features are relatively non-specific. worsening of the disease state. Decisions tains a private general dental practice
Alveolar osteitis (dry socket), sinusitis, gin- must be individualized and there should be
givitis, periodontitis, periapical pathology, an appropriate assessment of the risks and in Brooklyn, NY. Dr. Keenan served on
sarcoma, chronic sclerosing osteomyelitis, benefits. Since bisphosphonates accumulate the NYSAGD and the AGD Foundation
and TMJ disorders should constitute the and have long-term retention in bone, it is boards of trustees and is the president of
MRONJ differential diagnosis. not clear whether or not discontinuation for the NYSAGD for 2017.
any length of time will affect the course of
Since there is a lack of reliable data, man- the necrotic lesion. Denosumab, on the oth- Dr. Analia Veitz-Keenan is
agement recommendations for MRONJ in er hand, is not retained in bone, so its effects a practicing general den-
patients undergoing antiresorptive thera- are reversible following several months of tist and an AGD member.
py are not clearly defined and there is no discontinued administration. She holds the position of
consensus regarding a non-surgical versus a Clinical Associate Profes-
surgical approach. Recommended conser- Although the risk for the development of sor in the Department of
14
vative treatment includes limited debride- MRONJ appears to be low, it would be Oral Maxillofacial Pathology, Radiology
15
ment, the administration of antibiotics, and highly advisable for our medical colleagues and Medicine and is currently the Direc-
oral rinses such as chlorhexidine or hydro- to instruct their patients to seek a dental
gen peroxide. If soft tissue is chronically examination and to address dental needs tor of Evidence Based Dentistry in the
irritated or if there is loose bony sequestra, which would require surgical intervention Department of Epidemiology and Health
the contributing areas of necrotic bone can prior to the administration of antiresorptive Promotion at NYU College of Dentistry,
be removed or recontoured in order to pro- agents in an effort to minimize the risks for where she teaches to undergraduate and
mote healing. Necrotic bone should be re- its development and to maintain quality of post-graduate students, as well as coordi-
sected only in refractory or advanced cases life. nates and teaches activities for faculty. Dr.
and by an oral surgeon experienced with Veitz-Keenan has lectured in several na-
MRONJ. References: Please see the online version at tional and international dental meetings
www.nysagd.org. and has authored many articles in nation-
As for non-surgical treatment options such al and international journals. She main-
as pentoxifylline and vitamin E, low lev- tains a private practice in Brooklyn, NY.
el laser irradiation, hyperbaric oxygen,

NYU Oral Cancer Walk 2017 Raises Awareness and Support for Oral Cancer
Research – AGD Member Faculties Help with Oral Cancer Screenings

By Seung-Hee Rhee, DDS, MAGD
Photos by James Keenan, DDS, MAGD

On Sunday, April 23, 2017, NYU College of Dentistry hosted their annual NYU Oral
Cancer Walk supporting the NYU Oral Cancer Center and the Bluestone Center for
Clinical Research. More than 500 participants – including oral cancer survivors and
their families, dental students, residents, and faculty members - participated in the walk
to raise awareness for oral and pharyngeal cancer. It is a disease that kills over 8,000
Americans each year – approximately 1 every hour. The keys to survival are awareness,
prevention, and early detection. If detected in its earliest stages, oral cancer is easily
treated. More than $20,000 was raised for this worthy cause.
Many of our AGD members joined in this effort by participating in the walk or by making donations as TEAM NEW YORK AGD.
These registrations added significantly to the total funds raised.
While the walk was taking place outside, inside the NYU College of Dentistry clinic, dental students and faculty provided a free
oral cancer screening event to the general public from 11:00AM to 1:00PM. AGD was well represented during the screening as Drs.
Kay Oen, James Keenan, and Seung-Hee Rhee, who are AGD members and faculty
at NYU College of Dentistry, were present to lend a helping hand. Simultaneously,
NYC Free Clinic also provided valuable health screenings to the general public.
If you would like to know more about oral cancer, oral cancer research, or would
like to make a donation, please visit NYU Oral Cancer Center and Bluestone Center
for Clinical Research website at www.nyuoralcancer.org.
We hope you will join us next year!

www.nysagd.org l Fall 2017 l GP 31