Purpose: To evaluate the occurrence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in
patients exposed to nitrogen-containing bisphosphonates (NBPs) requiring surgical tooth extraction.
Patients and Methods: Sixty high-risk patients exposed to NBPs underwent surgical tooth extraction
with bone biopsy and were treated with a 7-day cycle of oral antibiotics and discontinuation of NBPs for
1 month. BRONJ was defined as the occurrence of any BRONJ stage (0-3) at 3, 6, or 12 months of
follow-up. Inferential analysis was performed on a per-bone (maxilla and/or mandible) basis (n 72).
The time to BRONJ was calculated, and age, gender, cancer diagnosis, and baseline osteomyelitis were
evaluated as potential predictors. Exact logistic regression was used to model the time-to-outcome
relationship, and hazard rates were calculated from logistic probabilities.
Results: BRONJ was detected at 3 months’ follow-up in 4 bones and at 6 months in 1 further bone. In
the whole cohort of bones, the hazard rate of BRONJ was 5.6% at 3 months and 1.5% at 6 months.
Baseline osteomyelitis was a strong risk factor for BRONJ development (odds ratio, 156.96; exact 95%
confidence interval, 18.99 to ; exact P .0001).
Conclusion: In this 12-month follow-up study, BRONJ was a rare outcome in high-risk NBP users who
underwent surgical tooth extraction. Moreover, baseline osteomyelitis was a very strong risk factor for
BRONJ development.
Product ID:
62263
Handle IRIS:
11562/363467
Deposited On:
March 29, 2012
Last Modified:
November 15, 2022
Bibliographic citation:
Saia, G.; Blandamura, S.; Bettini, Giordana; Tronchet, A.; Totola, Andrea; Bedogni, G.; Ferronato, G.; Nocini, Pier Francesco; Bedogni, Alberto,
Occurrence of bisphosphonate-related osteonecrosis of the jaw after surgical tooth extraction.«Journal of Oral and Maxillofacial Surgery»
, vol. 68
, n. 4
, 2010
, pp. 797-804