J Korean Assoc Oral Maxillofac Surg.  2017 Feb;43(1):16-22. 10.5125/jkaoms.2017.43.1.16.

Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea. kuksjs@pusan.ac.kr
  • 2Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan, Korea.

Abstract


OBJECTIVES
Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ.
MATERIALS AND METHODS
Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level.
RESULTS
BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and "˜responder group' and "˜non-responder group,' but there was no significant difference with the "˜worsened group.' In addition, the age of the patients was a relative factor with BRONJ stage.
CONCLUSION
With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

Keyword

Osteomyelitis; Bisphosphonate-associated osteonecrosis of the jaw; Chronic renal diseases

MeSH Terms

Bisphosphonate-Associated Osteonecrosis of the Jaw*
Busan
Creatinine
Diphosphonates
Filtration
Holidays
Human Body
Humans
Kidney
Oral and Maxillofacial Surgeons
Osteomyelitis
Renal Insufficiency, Chronic
Creatinine
Diphosphonates

Figure

  • Fig. 1 Renal excretion. Adapted from the Wikipedia: Renal function7.


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