Bisphosphonate related osteonecrosis of the jaws (BRONJ) in osteoporotic males

Abstract

BackgroundThe purpose of this study was to describe the clinical characteristics of bisphosphonate related osteonecrosis of the jaws (BRONJ) in osteoporotic males.MethodsThe medical records of BRONJ patients from 2007 to 2014 were reviewed. The data from only the male patients was extracted, and demographic data was collected and biochemical markers were measured.Results11 Patients out of 210 (5 %) being males. Among the 11 patients, the indication of bisphosphonate (BP) was osteoporosis in 9 patients, and cancer in two. In one of the osteoporosis patients, osteoporosis was thought to be secondary to hypogonadism after testicular tumor resection. Serum c-terminal telopetide crosslink of type I collagen (s-CTX) values ranged from 60 to 165 pg/mL (mean: 84.6 ± 36.8, median: 70). Serum osteocalcin (s-OC) ranged from 0 to 5.06 ng/mL (mean: 1.83 ± 1.66, median: 1.5) and vitamin D ranged from 0 to 11.9 (mean: 5.02 ± 4.92, median: 3.5).ConclusionBRONJ can be overlooked in male patients with osteoporosis. Although the incidence of BRONJ in males may be low, dentists should also check if their male patients are on osteoporosis treatment since osteoporosis in males can be manifested as a secondary disease to hypogonadism.

Clinical significance of drug cessation on medication-related osteonecrosis of the jaw in patients with osteoporosis

“…For this reason, the incidence of osteoporosis is higher in postmenopausal women than in men. However, the incidence of osteoporosis in men should not be overlooked, as it can arise due to and may manifest as a secondary disease 24 . Based on this principle, MRONJ in osteoporosis patients was mostly found in women.…”

A Study of the Experience of German Dental Practitioners with Patients on Bisphosphonates or Anticoagulants

“…In case surgery is required during drug intake, specific rules are to be followed. A possible complication is bisphosphonate-related osteonecrosis of the jaw (BRONJ) manifesting as exposed, nonvital bone that does not recover over 8 weeks after current or past bisphosphonate therapy (6,7,8,9,10,11,12) The mains steps included in the Germany clinical protocol for dental sanitation and care in patients receiving or planned to receive bisphosphonate therapy are as follows: (13,14,15)…”