Zoledronate, Smoking, and Obesity Are Strong Risk Factors for Osteonecrosis of the Jaw: A Case-Control Study

Wessel, John H.; Dodson, Thomas B.; Zavras, Athanasios I.

doi:10.1016/j.joms.2007.11.032

Cited by 175 publications

(139 citation statements)

References 25 publications

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“…Previous studies have identified steroid usage as a risk factor in BRONJ development (26,29). However, in the present study, steroid usage was not monitored as a risk factor (P=0.8).…”

Section: Discussioncontrasting

confidence: 67%

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

et al. 2015

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Abstract. Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe bone disease for which the pathogenetic mechanisms and risk factors are not fully understood. The present study evaluated the data of 652 patients with bone metastasis that had undergone treatment with biphosphonates. Subsequently, 24 patients with BRONJ and 20 control patients without BRONJ that were treated with zoledronic acid were enrolled. It was found that BRONJ occurred in 3.6% of patients. The mean age and the administration of dental treatment were found to be significantly associated with BRONJ development (P=0.049 and P=0.013, respectively). The cumulative dose median in the BRONJ group was found to be significantly higher compared with the cumulative dose average in the control group (P=0.037). In addition, at the time of BRONJ development, improvement in the disease was determined to be better in the BRONJ group than in the control group (P=0.031). The present study determined that age, the existence of dental extraction and the cumulative dose of zoledronate were all important risk factors in BRONJ development.

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“…Previous studies have identified steroid usage as a risk factor in BRONJ development (26,29). However, in the present study, steroid usage was not monitored as a risk factor (P=0.8).…”

Section: Discussioncontrasting

confidence: 67%

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

et al. 2015

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“…Cases with BRONJ may exhibit osteolytic lesions, sclerosis of cortical bone, reactive changes in the periosteal aspect, sequester formation as well as no radiographic signs. [19][20][21][22][23][24] BRONJ usually occurs more frequently in patients receiving nitrogen-containing bisphosphonates via parenteral route than oral administration. [24][25][26][27] Researchers reported the incidence of BRONJ after oral surgery (like tooth extraction) with cancer patients receiving intravenous bisphosphonates between 6.5% and 51.8%.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21][22][23][24] BRONJ usually occurs more frequently in patients receiving nitrogen-containing bisphosphonates via parenteral route than oral administration. [24][25][26][27] Researchers reported the incidence of BRONJ after oral surgery (like tooth extraction) with cancer patients receiving intravenous bisphosphonates between 6.5% and 51.8%. [28][29][30] Historically, the risk of developing osteonecrosis (at any site) is four times higher in cancer patients than in the normal population and has multiple risk factors, including previous/ concomitant chemotherapy, regular steroid therapy, immunosuppressant therapy, radiation therapy, diabetes, hypertension, obesity, certain gene mutations, tobacco habit, alcoholism 19,[24][25][26][27] as well as poor oral hygiene, chronic oral trauma, previously existing local infection and a history of dental procedures.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26][27] Researchers reported the incidence of BRONJ after oral surgery (like tooth extraction) with cancer patients receiving intravenous bisphosphonates between 6.5% and 51.8%. [28][29][30] Historically, the risk of developing osteonecrosis (at any site) is four times higher in cancer patients than in the normal population and has multiple risk factors, including previous/ concomitant chemotherapy, regular steroid therapy, immunosuppressant therapy, radiation therapy, diabetes, hypertension, obesity, certain gene mutations, tobacco habit, alcoholism 19,[24][25][26][27] as well as poor oral hygiene, chronic oral trauma, previously existing local infection and a history of dental procedures. [25][26][27]31,32 Zoledronic acid is known to be more potent than all the other bisphosphonates and it is reported that patients taking zoledronic acid are 30 times more likely to develop osteonecrosis.…”

Section: Discussionmentioning

confidence: 99%

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Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report

Akar

Efeoğlu

Alp³

et al. 2013

Renal Failure

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Adequate nutrition is imperative for a successful outcome in dialysis patients. Excellent oral hygiene and an efficient mastication can help to correct several metabolic and endocrine disturbances as well as delay initiation of dialysis in patients with chronic renal failure. However, concerns exist about the risk of malnutrition and protein depletion. On the other hand, intravenous bisphosphonates are the current standard of care for the treatment of hypercalcemia of malignancy and for the prevention of skeletal complications associated with bone metastases. Recently, retrospective case studies have reported an association between long-term bisphosphonate therapy and osteonecrosis of the jaws. This complication occurs either spontaneously or after minor dento-alveolar surgery including extraction of teeth. A malnourished dialysis patient who showed the typical clinical features of bisphosphonaterelated osteonecrosis of the jaw (BRONJ) without any obvious radiological changes in his panoramic radiograph is reported. To minimize the risk of BRONJ, patients initiated on bisphosphonates should optimize routine dental care and have their baseline oral health evaluated by both clinical and radiographic examinations before initiation of bisphosphonate therapy.

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“…Bifosfonat kullanımına bağlı gelişen kemik nekrozları intravenöz yolla kullanımda, oral yolla kullanımdan daha büyük bir risk oluştursa da, oral kullanım sonrasında da gelişen osteonekroz vakaları mevcuttur. [13][14][15] Bifosfonatların neden özellikle mandibula ve maksillada osteonekroz oluşturduğu kesin olarak açıklanamamıştır. Bifosfonatlar yenilenme oranı yüksek olan kemiklerde ve komşu yumuşak dokularda yüksek oranda biri- kirler.…”

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The Treatment of Intravenous Bisphosphonates Induced Osteonecrosis of the Mandible: Case Report

Eroğlu¹,

Alayli²,

Arpak³

2015

Turkiye Klinikleri J Dental Sci

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ifosfonatlar, kemik rezorbsiyonunun potansiyel inhibitörleridir ve yıl-lardır osteoporoz tedavisinde oral yolla kullanılan ilaç gruplarından-dır. Bununla birlikte intravenöz olarak Paget hastalığı, bazı kanserlerin Turkiye Klinikleri J Dental Sci 2015;21(3) 255 İntravenöz Bifosfonat Kullanımına Bağlı Olarak Mandibulada Gelişen Çene Kemiği Nekrozunun Tedavisi Ö ÖZ ZE ET T Bifosfanatlar, kemik turnoverını suprese eden ve osteoporoz gibi bening kemik hastalıkları ve iskeletal yapıyı etkileyen malignensi durumlarını önlemek için yaygın olarak reçete edilen ilaç-lardır. Çenelerin bifosfanat ilişkili osteonekrozu maksilla ve mandibuladaki kemiğin ekspoz olmasıyla karakterize bir durumdur. Bu hastalık; dental implant uygulamaları, apikal rezeksiyon, periodontal cerrahi uygulamalar ve diş çekimi gibi invaziv cerrahi işlemler sonrası ya da alveol kemiğin kendiliğinden ekspoz olması sonucu meydana gelmektedir. Olgumuzda; meme kanseri nedeniyle intravenöz bifosfanat tedavisi görmüş 41 yaşında kadın hasta, sol mandibular premolar ve molar bölgesinde diş çekimi sonrası meydana gelen ağrı ve enflamasyon nedeniyle kliniğimize baş-vurmuştur. Radyografik ve klinik incelemeler sonucu bifosfanat ilişkili osteonekroz tanısı konularak, antibiyotik baskısı altında nekroz alanı cerrahi girişimle temizlenip, iyileşmeyi hızlandırmak için ozon terapisi uygulanmıştır. Nekroz alanının iyileşmesini desteklemek amacıyla hasta hiperbarik oksijen tedavisine yönlendirilmiştir. Bu tedavi prosedürleri sonrası ilgili alanda yeni kemik oluşumu gözlenmiştir. Günümüzde, çene kemiğinin bifosfanat ilişkili osteonekroz olgularında kesin bir tedavi prosedürü bulunmamakla birlikte olgumuzda da gösterildiği üzere hiperbarik oksijen tedavisi bu olgularda umut verici olabilir.A An na ah ht ta ar r K Ke el li im me el le er r: : Çenenin bifosfonat ilişkili osteonekrozu; hiperbarik oksijenasyon; ozon; zoledronik asit A AB BS ST TR RA AC CT T Bisphosphonates are drugs that suppress bone turnover and are commonly prescribed to prevent skeletal related events in malignancy and for benign bone diseases such as osteoporosis. Bisphosphonate-induced osteonecrosis of jaws refers to a condition characterized by exposure of bone in the mandble or maxilla. The disease presents as exposed alveolar bone that occurs spontaneously or becomes evident following on invasive surgical procedure such as tooth removal, periodontal surgery, apicoectomy, or dental implant placement. In our case, 41-year-old woman patient with breast cancer referred to our clinic because of continued pain and inflammation on left mandible after the extraction. After clinical and radiologic examination, she has been diagnosed with biphosphonate induced osteonecrosis of the jaw. Under the pressure of antibiotic, the necrosis area was cleaned surgically and ozone therapy was applied to accelerate the healing. In order to support the healing of the necrosis area, patient have been directed by hyperbaric oxygen therapy. After these treatment procedures, secestre formation in bone and new bone formation ...

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Zoledronate, Smoking, and Obesity Are Strong Risk Factors for Osteonecrosis of the Jaw: A Case-Control Study

Cited by 175 publications

References 25 publications

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report

The Treatment of Intravenous Bisphosphonates Induced Osteonecrosis of the Mandible: Case Report

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