Risk Factors for Osteonecrosis of the Jaws

Case reports and cohort studies have linked bisphosphonate therapy and osteonecrosis of the jaws (ONJ), but neither causality nor specific risks for lesion development have been clearly established. We conducted a 1:3 case-control study with three dental Practice-based Research Networks, using denti...

Full description

Saved in:
Bibliographic Details
Published inJournal of dental research Vol. 90; no. 4; pp. 439 - 444
Main Authors Barasch, A, Cunha-Cruz, J, Curro, F A, Hujoel, P, Sung, AH, Vena, D, Voinea-Griffin, A E, Beadnell, Steven
Format Journal Article
LanguageEnglish
Published Alexandria SAGE PUBLICATIONS, INC 01.04.2011
Subjects
Cancer therapies
Case reports
Cytotoxicity
Demographics
Demography
Disease
Drug therapy
Family medical history
Intravenous administration
Jaw
Osteonecrosis
Osteoporosis
Patients
Radiation therapy
Risk factors
Studies
United States > US
Online AccessGet full text

Cover

More Information
Summary:Case reports and cohort studies have linked bisphosphonate therapy and osteonecrosis of the jaws (ONJ), but neither causality nor specific risks for lesion development have been clearly established. We conducted a 1:3 case-control study with three dental Practice-based Research Networks, using dentist questionnaires and patient interviews for collection of data on bisphosphonate therapy, demographics, co-morbidities, and dental and medical treatments. Multivariable logistic regression analyses tested associations between bisphosphonate use and other risk factors with ONJ. We enrolled 191 ONJ cases and 573 controls in 119 dental practices. Bisphosphonate use was strongly associated with ONJ (odds ratios [OR] 299.5 {95%CI 70.0-1282.7} for intravenous [IV] use and OR = 12.2 {4.3-35.0} for oral use). Risk markers included local suppuration (OR = 7.8 {1.8-34.1}), dental extraction (OR = 7.6 {2.4-24.7}), and radiation therapy (OR = 24.1 {4.9-118.4}). When cancer patients (n = 143) were excluded, bisphosphonate use (OR = 7.2 {2.1-24.7}), suppuration (OR = 11.9 {2.0-69.5}), and extractions (OR = 6.6 {1.6-26.6}) remained associated with ONJ. Higher risk of ONJ began within 2 years of bisphosphonate initiation and increased four-fold after 2 years. Both IV and oral bisphosphonate use were strongly associated with ONJ. Duration of treatment > 2 years; suppuration and dental extractions were independent risk factors for ONJ.
ISSN:0022-0345
1544-0591
DOI:10.1177/0022034510397196