Clinical experiences with bisphosphonate-associated osteonecrosis of the jaws: analysis of 21 cases
Received 10 March 2008 published online 09 March 2009.
Abstract
Purpose
The aim of the present study was to analyze the clinical presentation, risk factors, radiologic features, histopathologic and microbiological findings, treatment, and evolution of bisphosphonate-associated osteonecrosis of the jaws (BONJ).
Methods
This study made a retrospective review of 21 patients who underwent treatment and diagnosis of BONJ during 2004 to 2007 in a tertiary health care center reference for 1,100,000 inhabitants.
Results
The mean patient age at the time of presentation was 65.1 years. Of the 21 patients observed, 19 (90.4%) were receiving intravenous zoledronate. Of the 21 patients, 15 were treated with bisphosphonates for bone metastasis (71.4%), 5 for multiple myeloma (23.8%), and 1 for rheumatoid arthritis (4.7%). In 17 patients, the lesions occurred in the mandible. Fifteen patients had previous tooth extractions at the same site of bone necrosis.
Conclusion
In our series, most patients improved with conservative surgical debridement. Prospective clinical trials would enable clinicians to make accurate judgments about risk, treatment, and outcome for patients with BONJ.
aDepartment of Oral and Maxillofacial Surgery, University Central Hospital, Oviedo, Spain
bDepartment of Otorhinolaryngology, University Central Hospital, Oviedo, Spain
Corresponding author. Department Oral and Maxillofacial Surgery, University Central Hospital, Celestino Villamil s/n, 33009 Oviedo, Spain.
ABSTRACT