Resumen de Osteonecrosis of the jaws associated with chronic oral plus annual intravenous administration of bisphosphonates
Sacramento Bocanegra Pérez, Mario Vicente Barrero, Eduardo Rodríguez Bocanegra, Manuel Sosa Henríquez, M. L. Loras Caballero
Background: Osteonecrosis of the jaws (ONJ) is a relatively unknown clinical entity related with the prolonged use of oral bisphosphonates (BP); these drugs are mainly used for the treatment of osteoporosis. The actual incidence of ONJ is not known, although its tendency is expected to rise, given the large number of patients being treated with BP and their cumulative effect on bone. The aim of this study was to determine the clinical characteristics of affected patients as well as their clinical development with different treatment strategies. Method: Observational study conducted at the Department of Dentistry, Oral and Maxillofacial Surgery of the Hospital Universitario Insular, between March 2007 and November 2012. Data were gathered prospectively through interviews, clinical examination, laboratory tests and review of medical records. Results: The study included 15 female patients with a mean age of 75 years who were diagnosed ONJ. Osteoporosis was the most common underlying disease. Alendronate was the most frequently used bisphosphonate drug. Mandible was the most common location of ONJ. Earlier tooth extraction was found to be the main trigger for osteonecrosis. Risk factors included diabetes and corticosteroid use. The therapeutic approach was conservative or minimally invasive. Conclusions: Osteonecrosis of the jaw seems to affect elderly patients. Significant association was found between administered bisphosphonate dose, bisphosphonate potency, dental extraction, corticosteroid use and diabetes. Up to the moment, prevention is the best strategy to avoid this condition
