Osteonecrosis of the jaws associated with the use of bisphosphonates. Discussion over 52 cases

Rom J Morphol Embryol. 2011;52(4):1233-41.

Alm??an HA, B?ciu? M, Rotaru H, Bran S, Alm??an OC, B?ciu? G.

Source

Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Abstract

BACKGROUND:

Osteonecrosis of the jaws is increasing worldwide in patients treated with bisphosphonates.

STUDY DESIGN: 

A retrospective review of 52 patients who were treated during 2007-2010 for bisphosphonate related maxillofacial symptoms of the jaws was conducted. Patient characteristics and other factors that influenced the disease process were studied.

RESULTS:

Thirteen patients received bisphosphonates for the prevention or treatment of osteoporosis; 39 for preventing bone metastases from malignant tumors. Thirty-six patients were females (age range 32-87 years, median 64 years); 16 were males (age range 30-81 years, median 73.5 years). Bisphosphonate used was ibandronic acid in four cases, alendronate sodium in 14 cases, and zoledronic acid in 34 cases. Mean bisphosphonate treatment period was 22.44 months (95%CI 19.33-25.55). Thirty patients received intravenous, 22 received oral bisphosphonate. The average period until occurrence of maxillofacial symptoms was 6 months (range 0.5-24 months) in subjects with intravenous bisphosphonate and 12.26 months (range 0.25-36 months) in subjects with oral bisphosphonates (p=0.011).

CONCLUSIONS:

The risk of bisphosphonate related osteonecrosis of the jaws is very high twelve months after oral administration and six months after intravenous administration in patients who have a trigger point in the jaws area. A proper monitoring of patients receiving bisphosphonates can reduce the risk of osteonecrosis and can prevent complications