Abstract
BackgroundThe main objective of our study was to identify oral symptoms and signs most likely to be associated with the exposure of necrotic bone in bisphosphonate-related osteonecrosis of the jaw (BRONJ).Material and MethodsThe study group consisted of 183 patients with BRONJ. We recorded data on the underlying disease, bisphosphonate used, location of osteonecrosis, symptoms, pain, fistula development, suppuration, infection, exposed necrotic bone, and BRONJ stage.ResultsThe mean age of the patients was 68.22 ± 12.19 years. The sample included 118 (64.5%) women. Breast cancer and multiple myeloma were the most common underlying diseases, and 50 patients received oral bisphosphonates for osteoporosis. Dental extractions (69.4%) and mandibular location (74.3%) predominated. The only two variables influencing the possibility of necrotic bone exposure were intravenous bisphosphonate administration and the presence of an intraoral fistula (p >0.05).ConclusionsIntravenous bisphosphonate use and intraoral fistula presence were associated with a major predisposition to bone exposure in patients with BRONJ. Key words:Bisphosphonate, Osteonecrosis, Jaw.
Highlights
In 2003, Marx [1] reported a series of 36 cases of osteonecrosis of the jaw following bisphosphonate treatment for cancer
In the logistic regression analysis, necrotic bone exposure served as the dependent variable and age, sex, local factors, osteonecrosis location, underlying disease, mode of bisphosphonate administration, and the symptoms and signs described above served as independent variables
The only two variables that influenced the possibility of necrotic bone exposure were the mode of bisphosphonate administration and the presence of intraoral fistula (p < 0.05)
Summary
In 2003, Marx [1] reported a series of 36 cases of osteonecrosis of the jaw following bisphosphonate treatment for cancer. The concomitant use of other drugs, such as corticosteroids and antiangiogenic drugs, increases the risk of osteonecrosis [11] Local factors, such as tooth extraction [12,13,14,15], pre-existing periodontal problems, and implant or dental prosthesis use, can predispose patients to BRONJ [9]. The main objective of our study was to identify oral symptoms and signs most likely to be associated with the exposure of necrotic bone in bisphosphonate-related osteonecrosis of the jaw (BRONJ). We recorded data on the underlying disease, bisphosphonate used, location of osteonecrosis, symptoms, pain, fistula development, suppuration, infection, exposed necrotic bone, and BRONJ stage.
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