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  • "Bis-phossy jaws" - High and low risk factors for bisphosphonate-induced osteonecrosis of the jaw

    Author(s)
    H. Abu-Id, Mario
    H. Warnke, Patrick
    Gottschalk, Joachim
    Springer, Ingo
    Wiltfang, Jorg
    Acil, Yahya
    A.J. Russo, Paul
    Kreusch, Thomas
    Griffith University Author(s)
    Warnke, Patrick H.
    Year published
    2008
    Metadata
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    Abstract
    Introduction Bisphosphonates (BPs) have transformed our ability to treat certain malignancies, osteoporosis and hypercalcaemia. This class of drug is assumed to be well tolerated by most. There are some important caveats to this assumption, however, one of the significances being the risk of osteonecrosis of the jaw (ONJ). Material and methods This multi-centre retrospective study examined the role of different BPs on the development of ONJ, its clinical presentation and the efficacy of various treatment modalities, comparing these findings with the available literature. Results A total of 78 patients from 17 centres were ...
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    Introduction Bisphosphonates (BPs) have transformed our ability to treat certain malignancies, osteoporosis and hypercalcaemia. This class of drug is assumed to be well tolerated by most. There are some important caveats to this assumption, however, one of the significances being the risk of osteonecrosis of the jaw (ONJ). Material and methods This multi-centre retrospective study examined the role of different BPs on the development of ONJ, its clinical presentation and the efficacy of various treatment modalities, comparing these findings with the available literature. Results A total of 78 patients from 17 centres were identified with ONJ. A majority of patients identified with ONJ had used Pamidronate or Zoledronate (93.6%) intravenously. 94.9% of patients had received BP in the course of treatment for malignancies and a majority had also received prior chemotherapy or exogenous steroids. 82.1% of patients had received BP for more than 1 year. The mean time from the introduction of BP to the development of ONJ in 24 patients from our department was 31.8 months. Conclusions The most common intraoral manifestation was exposed necrotic jawbone. Tooth extractions and oral surgical intervention appear to place patients on BP therapy at risk of ONJ, especially after intravenous BP treatments. ONJ proved in this study to be remarkably refractory to treatment, with radical resection being the only curative approach. We recommend that all patients receive necessary dental treatment prior to commencing BP therapy.
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    Journal Title
    Journal of Cranio-Maxillofacial Surgery
    Volume
    36
    Issue
    2
    DOI
    https://doi.org/10.1016/j.jcms.2007.06.008
    Subject
    Dentistry not elsewhere classified
    Clinical Sciences
    Dentistry
    Publication URI
    http://hdl.handle.net/10072/65182
    Collection
    • Journal articles

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