Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb 1;6(1):e22-8.
doi: 10.4317/jced.51213. eCollection 2014 Feb.

Prognosis factors in the treatment of bisphosphonate-related osteonecrosis of the jaw - Prognostic factors in the treatment of BRONJ

Daigo Yoshiga  1 , Ikuo Nakamichi  2 , Yoshihiro Yamashita  3 , Noriaki Yamamoto  4 , Kensuke Yamauchi  5 , Shinnosuke Nogami  1 , Takeshi Kaneuji  1 , Sho Mitsugi  1 , Kenkou Tanaka  5 , Yoshihiro Kataoka  1 , Takuma Sakurai  1 , Hiroyasu Kiyomiya  1 , Ikuya Miyamoto  1 , Tetsu Takahashi  6
Affiliations

Prognosis factors in the treatment of bisphosphonate-related osteonecrosis of the jaw - Prognostic factors in the treatment of BRONJ

Daigo Yoshiga et al. J Clin Exp Dent. .

Abstract

Objectives: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a relatively rare but serious side effect of bisphosphonate (BP)-based treatments. This retrospective study aimed to investigate the risk factors and predictive markers in cases where patients were refractory to a recommended conservative treatment offered in our hospital.

Patients and methods: This single-center study collated the medical records of all patients treated for BRONJ between 2004 and 2011. A complete medical history, including detailed questionnaires, was collected for all patients, focusing on identifying underlying risk factors, clinical features, location and bone marker levels of BRONJ.

Results: The mean BRONJ remission rate was 57.6%, and the median duration of remission was seven months. Eighteen patients (34.6%) had persistent or progressive disease with a recommended conservative treatment for BRONJ. Notably, urinary cross-linked N-terminal telopeptide of type 1 collagen (NTX) levels in those resistant to conservative treatment tended to be lower than in patients that healed well.

Conclusions: We confirm that a significant proportion of BRONJ sufferers are refractory to a recommended conservative treatment and find that anticancer drugs, periodontal disease, the level of bone exposure and the dosage of intravenous BPs (e.g. zoledronate) represent specific risk factors in BRONJ that may determine the success of a recommended conservative treatment. Additionally, the NTX levels might be able to be a prognostic factor for the conservative treatment of BRONJ; additional research is necessary. Key words:Bisphosphonate, osteonecrosis, jaw, prognostic, retrospective.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: The authors have declared that no conflict of interest exist.

Figures

Figure 1
Figure 1
Kaplan-Meier curve showing the time after diagnosis until no further bone exposure was evident.
Figure 2
Figure 2
Urinary levels of bone resorption marker cross-linked amino-terminal telopeptide of type I collogen (NTX). The mean of the Persistent group was lower than that of the control and remission group but there was no significance (P = 0.11).
See this image and copyright information in PMC

References

    1. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. Task Force on Bisphosphonate-Related Osteonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw - 2009 update. Aust Endod J. 2009;35:119–30. - PubMed
    1. Ruggiero SL, Carlson ER, Assael LA. Comprehensive review of bisphosphonate therapy: Implications for the oral and maxillofacial surgery patient. J Oral Maxillofac Surg. 2009;67:1. - PubMed
    1. Chapurlat R, Delmas PD. New treatments in osteoporosis. Rev Med Interne 25 Suppl. 2004;25:S573–579. - PubMed
    1. Marx RE. Pamidronate (aredia) and zoledronate (zometa) induced avascular necrosis of the jaws: A growing epidemic. J Oral Maxillofac Surg. 2003;61:1115–7. - PubMed
    1. Erkan M, Bilgi O, Mutluoglu M, Uzun G. Bisphosphonate-related osteonecrosis of the jaw in cancer patients and hyperbaric oxygen therapy. JOP. 2009;10:579–80. - PubMed

LinkOut - more resources