Nonexposed Variant of Bisphosphonate-associated Osteonecrosis of the Jaw: A Case Series - 19/08/11
, Stephen R. Porter, MD, PhD a, Francesco D'Aiuto, MDM, MSc, PhD a, Suad Aljohani, DDS, MSc a, Paolo Vescovi, MD, PhD b, Maddalena Manfredi, DDS, PhD b, Paolo G. Arduino, DDS, MSc c, Roberto Broccoletti, DDS, MSc c, Anna Musciotto, DDS, PhD d, Olga Di Fede, DDS, PhD d, Tony S. Lazarovici, DMD e, Giuseppina Campisi, DDS, PhD d, Naom Yarom, DDS, MSc e, f
Requests for reprints should be addressed to Stefano Fedele, DDS, PhD, Oral Medicine Unit, Division of Maxillofacial, Diagnostic, Medical and Surgical Sciences, UCL Eastman Dental Institute, 256 Gray's Inn Road, London WC1X 8LD, UKAbstract |
Purpose |
To report a case series of patients with the nonexposed variant of bisphosphonate-associated osteonecrosis of the jaw—a form of jaw osteonecrosis that does not manifest with necrotic bone exposure/mucosal fenestration.
Methods |
Among 332 individuals referred to 5 clinical centers in Europe because of development of jawbone abnormalities after or during exposure to bisphosphonates, we identified a total of 96 patients who presented with the nonexposed variant of osteonecrosis. Relevant data were obtained via clinical notes; radiological investigations; patients' history, and referral letters.
Results |
The most common clinical feature of nonexposed osteonecrosis was jaw bone pain (88/96; 91.6%); followed by sinus tract (51%), bone enlargement (36.4%); and gingival swelling (17.7%). No radiological abnormalities were identified in 29.1% (28/96) of patients. In 53.1% (51/96) of the patients; nonexposed osteonecrosis subsequently evolved into frank bone exposure within 4.6 months (mean; 95% confidence interval; 3.6-5.6).
Conclusions |
Clinicians should be highly vigilant to identify individuals with nonexposed osteonecrosis, as the impact on epidemiological data and clinical trial design could be potentially significant. Although the present case series represents approximately 30% of all patients with bisphosphonates-associated osteonecrosis observed at the study centers, further population-based prospective studies are needed to obtain robust epidemiological figures.
Le texte complet de cet article est disponible en PDF.Keywords : Avascular necrosis, Bisphosphonates, Jawbones, Jaws, Mandible, Maxilla, Osteochemonecrosis, Osteonecrosis
Plan
| Funding: The authors declare no funding sources for preparation of this manuscript. |
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| Conflict of Interests: Dr. Yarom received lecture fees from Novartis and Bayer; all other authors declare no conflicts of interest. |
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| Authorship: All authors had access to the data and a significant role in writing the manuscript. |
Vol 123 - N° 11
P. 1060-1064 - novembre 2010 Retour au numéro
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