Nature and Frequency of Bisphosphonate-Associated Osteonecrosis of the Jaws in Australia

Mavrokokki, Tony; Cheng, A.; Stein, Brian; Goss, Alastair N.

doi:10.1016/j.joms.2006.10.061

Cited by 568 publications

(450 citation statements)

References 28 publications

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“…Of the adverse effects of BPs, BRONJ has also been recognized in non-cancer patients affected by osteometabolic diseases [22,23,29,36,42,44,47,49], but always impacting less than expected in cancer patients. The real risk for patients in therapy with BPs for osteometabolic diseases developing BRONJ is not really known, in part due to the paucity of crucial information, such as the exact total number of patients exposed to BP, and to the precise interplay of the high number of suspected risk factors implicated (Table 5).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: A retrospective multi-hospital-based study of 87 Italian cases

Fede

Fusco

Matranga

et al. 2013

European Journal of Internal Medicine

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Section: Discussionmentioning

confidence: 99%

“…The estimated prevalence of BRONJ in non-cancer (mainly osteoporotic) patients may range from 0.02% to 11% [22][23][24]29,33,36,42,44,47,49].…”

Section: European Journal Of Internal Medicine 24 (2013) 784-790mentioning

confidence: 99%

Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: A retrospective multi-hospital-based study of 87 Italian cases

Fede

Fusco

Matranga

et al. 2013

European Journal of Internal Medicine

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“…There is a risk of spontaneous BONJ occurring in any patient on bisphosphonates. Based on Australian data, 24 a dental extraction can increase this risk of BONJ by a factor of up to seven. The frequency of BONJ in osteoporotic patients was suggested as 1 in 2,260 to 8,470 (0.04% to 0.01%).…”

Section: Informed Consent/what Are the Risks?mentioning

confidence: 99%

“…If extractions were carried out, the calculated frequency of BONJ was 1 in 11 to 15 (9.1% to 6.67 %) and these would be more likely to be examples of progressive, severe and destructive BONJ. 24 The incidence of BONJ in women with post-menopausal osteoporosis who received once-yearly infusion of 5 mg of zoledronic acid (Recast®, Novartis AG) was determined in a large, prospective three-year clinical trial. Recent prospective data from this study found one case of BONJ among more than 7,000 patients, and is the only published evidence from a randomised, placebo-controlled clinical trial.…”

Section: Informed Consent/what Are the Risks?mentioning

confidence: 99%

Dental extractions and bisphosphonates: the assessment, consent and management, a proposed algorithm

Malden

Beltes²,

Lopes

2009

Br Dent J

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“…Risk factors such as administration route, indication, duration of treatment and administrated cumulative dose of biphosphonates have already been described. Several other factors also seem to favour ONJ occurrence, including dental risk factors (tooth extraction, periodontal disease, other surgical or invasive dental procedure), which were present in nearly 70% of reported cases, cancer and anti-cancer therapy (local radiotherapy, chemotherapy etc), corticosteroids and various comorbidities (diabetes, anaemia, among others) [9][10][11][12]. Only a few cases have been reported with alkylbiphosphonates.…”

Section: Introductionmentioning

confidence: 99%

Osteonecrosis of the jaw induced by clodronate, an alkylbiphosphonate: case report and literature review

Crépin

Laroche

et al. 2010

Eur J Clin Pharmacol

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Purpose To report on a case of osteonecrosis of the jaw (ONJ) in a patient treated with clodronate, an alkylbiphosphonate, and to draw attention to the risk of ONJ following treatment with all biphosphonates, whether they are alkyl-or amino-biphosphonates. Case report Beginning at age 58 years, a female patient took clodronate for almost 13 years for a metastatic bone cancer. She also underwent chemotherapy and radiotherapy. Three months after the end of biphosphonate therapy, she suffered from toothache, and tooth 27 (left maxillary second molar) was extracted. A maxillary focus of osteitis with an oral sinus communication was discovered, and a maxillofacial denture prosthesis was grafted in September 2006. Some days later, the patient consulted her dentist for an ulceration of the oral cavity floor in front of tooth 33 (left mandibular canine) extending to the left inferior side of the lip. In October 2006, teeth 33 and 34 (left mandibular first premolar) were extracted. No secondary infection occurred. A complete healing was only observed 3 months after the last extraction. ONJ due to alkylbiphosphonate treatment was diagnosed as bone reconstruction and mucous cicatrisation were delayed. Methods A systematic review was carried out to identify all cases of alkylbiphosphonate-induced ONJ by searching the Medline and Cochrane databases using 'osteonecrosis of the jaw', 'jaw diseases', 'osteonecrosis', 'diphosphonate', 'biphosphonate' (amino-, alkyl-or the international nonproprietary name) as the main search items. The search was limited to English-and French-language articles published between 1966 and February 2010. Results Our search identified 27 cases of alkylbiphosphonateinduced ONJ in the literature. Among these cases, only ten patients were on alkylbiphosphonate monotherapy; in the other cases, aminobiphosphonates had also been used. The clinical presentation of the alkylbiphosphonate-induced ONJ was similar to that most often encountered with aminobiphosphonate treatment. The duration of exposure before onset was higher with alkylbiphosphonates than with aminobiphosphonates, and dental procedures before ONJ were frequent. Conclusion Osteonecrosis of the jaw has been widely reported with various aminobiphosphonates, but data on the role of alkylbiphosphonates are scarce. As these latter drugs are less potent, a high cumulative dose through long-term exposure would appear to be necessary and would favour ONJ. Although the degree of risk for ONJ occurrence in patients on alkylbiphosphonates remains uncertain, it would be wise to reconsider carefully the indications for using these agents and to apply preventive measures as is currently done for aminobiphosphonates.

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Nature and Frequency of Bisphosphonate-Associated Osteonecrosis of the Jaws in Australia

Cited by 568 publications

References 28 publications

Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: A retrospective multi-hospital-based study of 87 Italian cases

Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: A retrospective multi-hospital-based study of 87 Italian cases

Dental extractions and bisphosphonates: the assessment, consent and management, a proposed algorithm

Osteonecrosis of the jaw induced by clodronate, an alkylbiphosphonate: case report and literature review

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