Cloud-Based Multicenter Data Collection and Epidemiologic Analysis of Bisphosphonate-Related Osteonecrosis of the Jaws in a Central European Population.

Tamás Vereb,Gábor Fülöp,Gusztáv Klenk,Krisztina Boda,László Seres,József Piffkó,László Czakó,Ferenc Oberna,Mihály Vaszilkó,Ágnes Janovszky

doi:10.3390/jcm9020426

Abstract

Objective: Bisphosphonate-related osteonecrosis of the jaws is considered to be a rare but severe complication of bisphosphonate therapy. To understand this condition better, data collection is essential. Although the number of scientific papers about this subject is large, to date only a few multicenter reports have been published. Study design: We present a novel cloud-based data collection system for the evaluation of the risk factors of bisphosphonate-related osteonecrosis of the jaws. Web-based questionnaire and database have been set up and made available to voluntary researchers and clinicians in oral and maxillofacial surgery in Hungary and Slovakia. Results: To date, fifteen colleagues from eight maxillofacial units have joined the study. Data of 180 patients have been recorded. Collected data were statistically analysed and evaluated from an epidemiological point of view. Conclusions: Authors consider cloud-based multicenter data collection a useful tool that allows for real-time collaboration between users, facilitates fast data entry and analysis, and thus considerably contributes to widening our knowledge of bisphosphonate-related osteonecrosis of the jaws.

Highlights

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) was first reported in 2003 by Marx [1]
To distinguish BRONJ from other delayed healing conditions, in 2007 the following definition was suggested by the American Association of Oral and Maxillofacial Surgeons: ‘’patients may be considered to have BRONJ if all of the following three characteristics are present: current or previous treatment with a bisphosphonate; exposed bone in the maxillofacial region that has persisted for more than eight weeks; and no history of radiation therapy to the jaws” [5]
In 2014, the revised AAOMS Position Paper recommended changing the nomenclature of BRONJ to MRONJ, and the working definition of this condition was modified to accommodate the growing number of osteonecrosis cases associated with other antiresorptive and antiangiogenic therapies (Table 1) [6]

Summary

Introduction

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) was first reported in 2003 by Marx [1]. To distinguish BRONJ from other delayed healing conditions, in 2007 the following definition was suggested by the American Association of Oral and Maxillofacial Surgeons: ‘’patients may be considered to have BRONJ if all of the following three characteristics are present: current or previous treatment with a bisphosphonate; exposed bone in the maxillofacial region that has persisted for more than eight weeks; and no history of radiation therapy to the jaws” [5]. In 2014, the revised AAOMS Position Paper recommended changing the nomenclature of BRONJ to MRONJ (medication-related osteonecrosis of the jaw), and the working definition of this condition was modified to accommodate the growing number of osteonecrosis cases associated with other antiresorptive (denosumab) and antiangiogenic therapies (Table 1) [6]. Definition of Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ) (AAOMS 2009).

Methods

Results

Conclusion