Abstract

OBJECTIVE
The objective of this study was to define the clinical characteristics of osteonecrosis of the jaws (ONJ) induced by oral bisphosphonates in a series of patients from a circumscribed area in northwest Spain.
STUDY DESIGN
A retrospective multicentre study was undertaken in 3 hospitals in an area with a radius less than 100 km in the Autonomous Community of Galicia (Spain). The medical records were reviewed and an oral examination was performed of patients diagnosed with oral bisphosphonate-related ONJ in the previous 3 years.
RESULTS
We detected 20 cases of ONJ (24 lesions) related to oral bisphosphonates (alendronate [16 patients] and ibandronate [4 patients]), which were mainly administered as treatment for osteoporosis (17 patients). The mean interval between initiation of treatment and confirmation of a diagnosis of ONJ was 66±43 months (range, 6-132 months); in 7 patients (35%) the interval was less than 36 months. The past history revealed hypertension in 13 cases (65%) and diabetes in 4 (20%); 7 patients (35%) were on corticosteroid treatment. Oral surgery had been previously performed in 13 patients (65%) and the remaining 7 patients (35%) had removable dental prostheses. The lesions most frequently affected the posterior mandible (62.5%). The majority of the lesions (75%) were classified as stage 2, although lesions were identified in all established clinical stages (including 2 stage 0 lesions).
CONCLUSION
In conclusion, in the present series, ONJ induced by oral bisphosphonates typically develops in women around 70 years of age, taking alendronate, that underwent oral surgery. Most lesions are located in the posterior mandible and are classified as stage 2 at diagnosis. Some patients presented no known risk factors, suggesting that there may be risk factors still to be identified. There are well-defined patterns of clinical presentation that can facilitate early diagnosis of ONJ.

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Authors

Diniz-Freitas M, López-Cedrún JL, Fernández-Sanromán J, García-García A, Fernández-Feijoo J, Diz-Dios P

Institution

Oral Medicine Unit, School of Medicine and Dentistry, University of Santiago de Compostela-Spain, 15782-Santiago de Compostela, Spain. marcio.diniz@usc.es

Source

Medicina oral, patología oral y cirugía bucal 17:5 2012 pg e751-8

MeSH

Aged
Aged, 80 and over
Alendronate
Bisphosphonate-Associated Osteonecrosis of the Jaw
Bone Density Conservation Agents
Diphosphonates
Female
Humans
Male
Middle Aged
Retrospective Studies
Spain

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22549688