Resolution of Oral Bisphosphonate and Steroid-Related Osteonecrosis of the Jaw—A Serial Case Analysis

Bisphosphonate-Related Osteonecrosis of the Jaw in Patients With Oral Bisphosphonate Exposure: Clinical Course and Outcomes

“…[28][29][30][31] Chronic glucocorticoid therapy likewise has adverse effects on bone metabolism, including impaired osteoblastic differentiation and function, 26 and the additional immunosuppressive and antiangiogenic effects of glucocorticoids can play an important role in the development of oral BRONJ. Chiu et al 27 suggested that chronic steroid use contributes to an earlier presentation of BRONJ with more advanced disease and delayed healing, 27 consistent with current American Association of Oral and Maxillofacial Surgeons guidelines suggesting that concomitant glucocorticoid therapy poses an additional risk of BRONJ after dentoalveolar surgery. 24 We also noted that 15% of our BRONJ cohort received DMARD therapy (2 without concomitant glucocorticoids).…”

Resective Surgical Approach Shows a High Performance in the Management of Advanced Cases of Bisphosphonate-Related Osteonecrosis of the Jaws: A Retrospective Survey of 347 Cases

“…Indeed, corticosteroids appear to be associated with more severe BRONJ lesions, with an unpredictable prognosis. 30 Steroids are routinely incorporated into anticancer therapeutic regimens and may be administered intravenously or orally. Although steroid use has long been associated with osteonecrosis of the long bones, the role of corticosteroids in the pathogenesis of osteonecrosis is unclear.…”

A study of 225 patients on bisphosphonates presenting to the bisphosphonate clinic at King's College Hospital

“…Our findings are consistent with studies demonstrating a positive correlation between the incidence of BRONJ and duration of BP therapy. 5,[12][13][14][16][17][18] The use of concomitant steroids has been documented to increase the incidence of BRONJ although some studies have not supported this. In the current study there was a significant correlation between steroid use and development of a BRONJ, p = 0.003 ( Table 2).…”