RESEARCH - Bisphosphonate-related osteonecrosis of the jaws: a single-center study of 101 patients

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J Oral Maxillofac Surg. 2009 Apr;67(4):850-5.

Bisphosphonate-related osteonecrosis of the jaws: a single-center

study of 101 patients.

Lazarovici TS, Yahalom R, Taicher S, Elad S, Hardan I, Yarom N.

Department of Oral and Maxillofacial Surgery, Sheba Medical Center,

Tel-Hashomer, Israel.

PURPOSE: Osteonecrosis of the jaw (ONJ) is a devastating side effect

of long-term bisphosphonate (BP) use. We present the largest case

series from a single department.

MATERIALS AND METHODS: This case series included 101 ONJ patients.

Data on demographics, medical background, type and duration of BP use,

possible triggering events, mode of therapy, and outcome were

recorded.

RESULTS: ONJ was associated with intravenous BPs in 85 patients and

with oral BPs in 16 patients. It was diagnosed after 48, 27, and 67

months of pamidronate, zoledronic acid, and alendronate use,

respectively. Long-term antibiotics and minimal surgical procedures

resulted in complete or partial healing in 18% and 52% of the

patients, respectively; 30% had no response. There was no association

between ONJ and diabetes, steroid and antiangiogenic treatment, or

underlying periodontal disease. Diagnostic biopsies aggravated lesions

without being informative about pathogenesis. A conservative regimen

is our treatment of choice.

CONCLUSION: Solutions for decreasing morbidity and poor outcome of ONJ

remain elusive.

PMID: 19304045

http://www.ncbi.nlm.nih.gov/pubmed/19304045

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