Brief observationNonexposed Variant of Bisphosphonate-associated Osteonecrosis of the Jaw: A Case Series
Section snippets
Methods
Between 2007 and 2009, 332 individuals had been referred to 5 clinical centers in Europe with possible diagnosis of bisphosphonate-associated osteonecrosis of the jaw because of development of jawbone abnormalities after/during exposure to bisphosphonate medications. A total of 96 patients (29.8%) presented jawbone manifestations that fulfilled the description of presumed nonexposed variant of bisphosphonate-associated osteonecrosis of the jaws, as described in previous reports.2, 14, 15, 16
Results
Ninety-six (28.9%) of 332 (71.1%) patients were diagnosed with nonexposed bisphosphonate-associated osteonecrosis of the jaws (Table 1). Thirty were male and 66 female, and their age ranged from 38 to 90 years (mean: 68 years, 95% confidence interval [CI], 66-71). The underlying diseases that required treatment with bisphosphonate included multiple myeloma (43 patients, 44.8%), osteoporosis (25 patients, 26.04%), metastasizing breast cancer (19 patients, 19.8%), prostate cancer (5 patients,
Discussion
The present observational study is the largest published series of patients who had been exposed to bisphosphonates and developed jaw bone symptoms/signs in the absence of bone exposure. These patients were classified as being affected by nonexposed bisphosphonate-associated osteonecrosis of the jaw because: 1) there was no obvious evidence of dental infection or other jaw bone disease (eg, metastases) that could cause those symptoms/signs, and 2) some of them subsequently developed frank bone
Acknowledgment
This work was undertaken at University College London/University College London Hospital, which received a proportion of funding from the Department of Health's National Institute for Health Research Biomedical Research Centre funding scheme.
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Funding: The authors declare no funding sources for preparation of this manuscript.
Conflict of Interests: Dr. Yarom received lecture fees from Novartis and Bayer; all other authors declare no conflicts of interest.
Authorship: All authors had access to the data and a significant role in writing the manuscript.