Prognosis factors in the treatment of bisphosphonate-related osteonecrosis of the jaw - Prognostic factors in the treatment of BRONJ

Daigo Yoshiga, Ikuo Nakamichi, Yoshihiro Yamashita, Noriaki Yamamoto, Kensuke Yamauchi, Shinnosuke Nogami, Takeshi Kaneuji, Sho Mitsugi, Kenkou Tanaka, Yoshihiro Kataoka, Takuma Sakurai, Hiroyasu Kiyomiya, Ikuya Miyamoto, Tetsu Takahashi

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Objectives: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a relatively rare but serious side effect of bisphosphonate (BP)-based treatments. This retrospective study aimed to investigate the risk factors and predictive markers in cases where patients were refractory to a recommended conservative treatment offered in our hospital. Patients and Methods: This single-center study collated the medical records of all patients treated for BRONJ between 2004 and 2011. A complete medical history, including detailed questionnaires, was collected for all patients, focusing on identifying underlying risk factors, clinical features, location and bone marker levels of BRONJ. Results: The mean BRONJ remission rate was 57.6%, and the median duration of remission was seven months. Eighteen patients (34.6%) had persistent or progressive disease with a recommended conservative treatment for BRONJ. Notably, urinary cross-linked N-terminal telopeptide of type 1 collagen (NTX) levels in those resistant to conservative treatment tended to be lower than in patients that healed well. Conclusions: We confirm that a significant proportion of BRONJ sufferers are refractory to a recommended conservative treatment and find that anticancer drugs, periodontal disease, the level of bone exposure and the dosage of intravenous BPs (e.g. zoledronate) represent specific risk factors in BRONJ that may determine the success of a recommended conservative treatment. Additionally, the NTX levels might be able to be a prognostic factor for the conservative treatment of BRONJ; additional research is necessary.

Original languageEnglish
Pages (from-to)e22-e28
JournalJournal of Clinical and Experimental Dentistry
Volume6
Issue number1
DOIs
Publication statusPublished - 2014 Feb

Keywords

  • Bisphosphonate
  • Jaw
  • Osteonecrosis
  • Prognostic
  • Retrospective

ASJC Scopus subject areas

  • Dentistry(all)

Fingerprint Dive into the research topics of 'Prognosis factors in the treatment of bisphosphonate-related osteonecrosis of the jaw - Prognostic factors in the treatment of BRONJ'. Together they form a unique fingerprint.

Cite this