scholarly journals Osteonecrosis of the Jaw Involving Bisphosphonate Treatment for Osteoporosis

Osteoporosis ◽  
10.5772/31089 ◽  
2012 ◽  
Author(s):  
Maria Panas ◽  
Magorzata Zaleska ◽  
Tomasz Kaczmarzyk
Author(s):  
Seung-Hun Lee ◽  
So-Young Choi ◽  
Min-Su Bae ◽  
Tae-Geon Kwon

Abstract Purpose This retrospective study was aimed to evaluate the clinical characteristics and treatment outcomes in patients with osteonecrosis of the jaw who were receiving oral versus intravenous (IV) bisphosphonate (BP). Materials and methods This retrospective study enrolled subjects who had been diagnosed with medication-related osteonecrosis of the jaw (MRONJ) during the period from July 2010 to June 2014. Information regarding the following demographic and clinical characteristics was collected: demographic data, administration route and type of BP, duration of BP medication, primary disease, number of involved sites, location of the lesion, number of surgeries, outcome of treatments, and laboratory test. All the patients were divided into oral and IV BP groups; and the between-group differences were compared. Results Total 278 patients were divided into two groups as per the route of BP administration. The proportion of oral BP-related MRONJ group were more dominant over IV BP group (oral BP, n = 251; IV BP, n = 27). In the IV BP group, the average dosing duration (31.4 months) was significantly shorter than that in the oral BP group (53.1 months) (P < 0.001). The average number of involved sites in the oral BP group (1.21 ± 0.48) was smaller than that in the IV BP group (1.63 ± 0.84) (P < 0.001). The average number of surgeries was higher in the IV BP group (1.65 ± 0.95) as compared to that in the oral BP group (0.98 ± 0.73) (P < 0.001). Outcome after the surgery for MRONJ after IV BP was poor than oral BP group. Conclusion IV administration of BP causes greater inhibition of bone remodeling and could lead more severe inflammation. Therefore, even if the duration of IV administration of BP is shorter than that of oral BP, the extent of the lesion could be more extensive. Therefore, the result suggests that the MRONJ after IV BP for cancer patients needs to be considered as different characteristics to oral BP group for osteoporosis patents.


2005 ◽  
Vol 23 (34) ◽  
pp. 8580-8587 ◽  
Author(s):  
Aristotle Bamias ◽  
Efstathios Kastritis ◽  
Christina Bamia ◽  
Lia A. Moulopoulos ◽  
Ioannis Melakopoulos ◽  
...  

Purpose Osteonecrosis of the jaw (ONJ) has been associated recently with the use of pamidronate and zoledronic acid. We studied the incidence, characteristics, and risk factors for the development of ONJ among patients treated with bisphosphonates for bone metastases. Patients and Methods ONJ was assessed prospectively since July 2003. The first bisphosphonate treatment among patients with ONJ was administered in 1997. Two hundred fifty-two patients who received bisphosphonates since January 1997 were included in this analysis. Results Seventeen patients (6.7%) developed ONJ: 11 of 111 (9.9%) with multiple myeloma, two of 70 (2.9%) with breast cancer, three of 46 (6.5%) with prostate cancer, and one of 25 (4%) with other neoplasms (P = .289). The median number of treatment cycles and time of exposure to bisphosphonates were 35 infusions and 39.3 months for patients with ONJ compared with 15 infusions (P < .001) and 19 months (P = .001), respectively, for patients with no ONJ. The incidence of ONJ increased with time to exposure from 1.5% among patients treated for 4 to 12 months to 7.7% for treatment of 37 to 48 months. The cumulative hazard was significantly higher with zoledronic acid compared with pamidronate alone or pamidronate and zoledronic acid sequentially (P < .001). All but two patients with ONJ had a history of dental procedures within the last year or use of dentures. Conclusion The use of bisphosphonates seems to be associated with the development of ONJ. Length of exposure seems to be the most important risk factor for this complication. The type of bisphosphonate may play a role and previous dental procedures may be a precipitating factor.


2019 ◽  
Vol 33 (2) ◽  
pp. 862-867 ◽  
Author(s):  
Melinda J. Larson ◽  
Ashley B. Oakes ◽  
Ember Epperson ◽  
Dennis J. Chew

Bone ◽  
2009 ◽  
Vol 44 ◽  
pp. S235-S236 ◽  
Author(s):  
D. Felsenberg ◽  
B. Hoffmeister ◽  
T. Jung ◽  
S. Lopez-Schüler ◽  
O. Bock

2014 ◽  
Vol 1 (1) ◽  
pp. 19-24
Author(s):  
Irene García-Ávila ◽  
◽  
Sofía Hernández-Montero ◽  
Javier de la Cruz-Perez ◽  
Raul Casado-Estebaranz ◽  
...  

2018 ◽  
Vol 132 (4) ◽  
pp. 372-374 ◽  
Author(s):  
L McCadden ◽  
C G Leonard ◽  
W J Primrose

AbstractBackground:Oesophageal disorders and osteonecrosis of the jaw are recognised complications of the commonly prescribed medication bisphosphonate. Despite these diagnoses being seen comparatively frequently within the ENT clinic, osteonecrosis of the external ear is a less well reported complication.Methods:The current literature is reviewed and our experience with six cases of bisphosphonate-related ear canal osteonecrosis is presented.Results:Six cases were identified as suffering from ear canal osteonecrosis as a result of bisphosphonate treatment. One of our cases suffered bilateral ear canal osteonecrosis after only 20 months of oral alendronic acid treatment. Management ranged from bisphosphonate cessation and topical treatment, to surgical debridement in the operating theatre.Conclusion:Bisphosphonate-related ear canal osteonecrosis is undoubtedly under-diagnosed. For such a commonly prescribed medication, the risks and side effects of bisphosphonate should be better known and long-term treatment should be avoided if possible.


NEMESIS ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Michele Magremanne ◽  
Anne Grysolle ◽  
Hervé Reychler

Objective: Paget’s disease of bone is characterized by a focal increase in bone resorption and accelerated bone formation leading to a weaker and disorganised bone. Bisphosphonates (BPs) have been the treatment of choice of Paget’s disease since the 1990s. Medication related osteonecrosis of the jaw (MRONJ) is a rare event in non oncologic patients. We describe a rare case of  Paget’s disease involving the maxilla with osteonecrosis in a context of bisphosphonate treatment.   Case report: an 87-year-old woman presented with 4 episodes of bone necrosis in 15 years. In this case report there is a clear chronologic association between the occurrence of MRONJ and the administration of iv BP for Paget’s disease. Maxillofacial involvement of Paget’s disease occurs in less than 15% of cases. There is a lack of information in the literature about the association of MRONJ and Paget’s disease. Even if osteonecrosis of the jaw could be a consequence of the disease, in this case, it is more in relation to the BP treatment.   Conclusions: Although MRONJ might be considered a rare condition in Paget’s disease, patients prior to starting antiresorptive therapy and in particular iv BPs should have a complete dental examination and panoramic X-Ray.   Nemesis relevance: side effect of bisphosphonate treatment  


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