RT Journal Article
SR Electronic
T1 Bisphosphonate Associated Osteonecrosis of the Jaw
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 478
OP 490
DO 10.3899/jrheum.080759
VO 36
IS 3
A1 ALIYA A. KHAN
A1 GEORGE K.B. SÁNDOR
A1 EDWARD DORE
A1 ARCHIBALD D. MORRISON
A1 MAZEN ALSAHLI
A1 FAIZAN AMIN
A1 EDMUND PETERS
A1 DAVID A. HANLEY
A1 SULTAN R. CHAUDRY
A1 BRIAN LENTLE
A1 DAVID W. DEMPSTER
A1 FRANCIS H. GLORIEUX
A1 ALAN J. NEVILLE
A1 REENA M. TALWAR
A1 CAMERON M. CLOKIE
A1 MAJD AL MARDINI
A1 TERRI PAUL
A1 SUNDEEP KHOSLA
A1 ROBERT G. JOSSE
A1 SUSAN SUTHERLAND
A1 DAVID K. LAM
A1 ROBERT P. CARMICHAEL
A1 NICK BLANAS
A1 DAVID KENDLER
A1 STEVEN PETAK
A1 LOUIS GEORGES STE-MARIE
A1 JACQUES BROWN
A1 A.WAYNE EVANS
A1 LORENA RIOS
A1 JULIET E. COMPSTON
YR 2009
UL http://www.jrheum.org/content/36/3/478.abstract
AB In 2003, the first reports describing osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates (BP) were published. These cases occurred in patients with cancer receiving high-dose intravenous BP; however, 5% of the cases were in patients with osteoporosis receiving low-dose bisphosphonate therapy. We present the results of a systematic review of the incidence, risk factors, diagnosis, prevention, and treatment of BP associated ONJ. We conducted a comprehensive literature search for relevant studies on BP associated ONJ in oncology and osteoporosis patients published before February 2008.All selected relevant articles were sorted by area of focus. Data for each area were abstracted by 2 independent reviewers. The results showed that the diagnosis is made clinically. Prospective data evaluating the incidence and etiologic factors are very limited. In oncology patients receiving high-dose intravenous BP, ONJ appears to be dependent on the dose and duration of therapy, with an estimated incidence of 1%–12% at 36 months of exposure. In osteoporosis patients, it is rare, with an estimated incidence < 1 case per 100,000 person-years of exposure. The incidence of ONJ in the general population is not known. Currently, there is insufficient evidence to confirm a causal link between low-dose BP use in the osteoporosis patient population and ONJ. We concluded BP associated ONJ is associated with high-dose BP therapy primarily in the oncology patient population. Prevention and treatment strategies are currently based on expert opinion and focus on maintaining good oral hygiene and conservative surgical intervention.