Poster 022: Osteonecrosis of Jaw Associated With Oral Application of Bisphosphonates

Epidemiological aspects of rheumatoid arthritis patients affected by oral bisphosphonate-related osteonecrosis of the jaws

“…Of note, a large proportion of BRONJ lesions appeared spontaneously (41.38%) [9,10,12,13,15,19-21] (Table 2). …”

“…The main signs and symptoms reported in the studies included: bone exposure in 82% of the lesions [4,6,7,9,11-18,20,21], followed by pain (78.5%) [4,6,7,10-14,16-21], edema (35.7%) [6,7,10,12,15,17-19,21] and purulent discharge (35.7%) [6,11,13-15,17,19,21]. Moreover, according to a staging system [9], 28 lesions were diagnosed at stage II or III, and only one was at stage I (Table 2).…”

“…The treatment only with conservative therapy was associated with the most positive outcomes, including the complete healing of the lesions (33.3%) [9,12], partial and general positive results (58.3%) [10,14,19,20] and only one patient presented a non-healed lesion (8.33%) [17] (Table 4). …”

“…The patients from this literature review ranged in age from 55 to 79 yr and the mean age was 67 years. Among the 22 patients whose age was reported, 17 (77.3%) were above 60 years old [ 6 , 8 , 10 - 12 , 14 - 16 , 18 - 21 ], 25 patients reported the gender and only one was male [ 12 ] (Table 1 ). Furthermore, osteoporosis was the most common co-morbidity observed in this review, being present in 18 patients (66.6%) [ 4 , 9 - 11 , 14 - 16 , 18 - 21 ], followed by hypertension (29.6%) [ 6 , 16 , 18 - 20 ] and diabetes mellitus (14.8%) [ 8 , 15 , 20 ] (Table 1 ).…”

“…Among the 24 patients that reported the use of BPs, 22 (91.6%) affirmed to use alendronate [ 4 , 6 - 9 , 11 , 12 , 15 , 16 , 18 - 21 ], while 2 other patients were using ibandronate [ 14 ] or risedronate [ 10 ] (Table 1 ). The mean duration of BP therapy was 48 months, ranging from 6 months to 10 years, and most of the patients (73%) were using BPs for 3 or more years [ 4 , 6 , 9 , 12 , 15 - 17 , 19 - 21 ] (Table 1 ).…”