J Korean Soc Osteoporos.  2010 Apr;8(1):73-81.

Bisphosphonate-Related Osteonecrosis of the Jaw: Clinical Characteristics of Patients in Korea

Affiliations
  • 1Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
  • 2Department of Oral and Maxillofacial Surgery, Ajou University School of Medicine, Suwon, Korea.
  • 3Department of Oral and Maxillofacial Surgery, Kyung Hee University School of Dentistry, Seoul, Korea.
  • 4Department of Preventive and Public Health Dentistry, Kyung Hee University School of Dentistry, Seoul, Korea.
  • 5Department of Nuclear Medicine, Kyung Hee University School of Medicine, Seoul, Korea. petct@paran.com

Abstract


OBJECTIVES
The purpose of this study is to describe the clinical characteristics of patients diagnosed with bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to identify potential risk factors.
METHODS
Twenty cases were identified who were diagnosed as BRONJ at the Ajou University Hospital and Kyung Hee University Hospital. We performed a retrospective review of charts.
RESULTS
Fifteen cases of BRONJ were developed in patients with osteoporosis treated with oral bisphosphonates while 5 cases were developed in patients with malignancy treated with IV bisphosphonates. Mean age of BRONJ group was 69.4 (48~84) years-old and 14 of 20 (70%) were women. Eleven cases (55%) occurred in the maxilla and 9 cases (45%) occurred in the mandible. Six out of 20 (30%) had history of diabetes mellitus, 4 out of 20 (20%) had history of rheumatoid arthritis, 6 out of 20 (30%) took glucocorticoid, and 15 of 20 (75%) had dental extractions before diagnosis of BRONJ. The mean duration of bisphosphonates administration was 3.3 (SD=0.5) years. The management of BRONJ was surgical in 17 patients, nonsurgical in two patients and one patient was lost to follow up.
CONCLUSION
Old age, female sex, and previous invasive dental procedure were the most common characteristics of those who developed BRONJ. Concomitant disease including diabetes mellitus, glucocorticoid use might influence the development of BRONJ.

Keyword

Bisphosphonate; Osteonecrosis of the jaw; Old age; Female sex; Previous dental procedures

MeSH Terms

Arthritis, Rheumatoid
Bisphosphonate-Associated Osteonecrosis of the Jaw
Diabetes Mellitus
Diphosphonates
Female
Humans
Korea
Mandible
Maxilla
Osteonecrosis
Osteoporosis
Retrospective Studies
Diphosphonates
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