Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates
Abstract Bisphosphonates (BPs) have been used in medical practice for the treatment of osteoporosis, bone metastasis, and multiple myeloma. Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study inc...
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| Veröffentlicht in: | International journal of oral and maxillofacial surgery 2015-07, Vol.44 (7), p.840-844 |
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| creator | Shintani, T Hayashido, Y Mukasa, H Akagi, E Hoshino, M Ishida, Y Hamana, T Okamoto, K Kanda, T Koizumi, K Yoshioka, Y Tani, R Toratani, S Okamoto, T |
| description | Abstract Bisphosphonates (BPs) have been used in medical practice for the treatment of osteoporosis, bone metastasis, and multiple myeloma. Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study included 59 patients with BRONJ: 29 had taken oral BPs and 30 had taken intravenous (IV) BPs. All received conservative treatments. When separated sequestra were seen, a sequestrectomy was performed. Segmental mandibular resection was performed when pathological fractures were diagnosed. The outcomes of treatments were compared between groups. For patients treated with oral rinses or mandibular resection, the number in whom clinical healing was observed did not differ between the oral BP and IV BP groups. With regard to sequestrectomy, 94% of patients in the oral BP group showed improvement with this treatment compared to 50% in the IV BP group. The number of patients in whom clinical healing of BRONJ was achieved was statistically better in the oral BP group than in the IV BP group after 6 months of treatment ( P < 0.001). The results showed that >90% of patients treated with oral BPs could be cured. However, 50% of patients treated with IV BPs did not show an improvement. Additional research is needed to further increase the therapeutic efficacy for the resolution of BRONJ. |
| doi_str_mv | 10.1016/j.ijom.2015.03.013 |
| format | Article |
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Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study included 59 patients with BRONJ: 29 had taken oral BPs and 30 had taken intravenous (IV) BPs. All received conservative treatments. When separated sequestra were seen, a sequestrectomy was performed. Segmental mandibular resection was performed when pathological fractures were diagnosed. The outcomes of treatments were compared between groups. For patients treated with oral rinses or mandibular resection, the number in whom clinical healing was observed did not differ between the oral BP and IV BP groups. With regard to sequestrectomy, 94% of patients in the oral BP group showed improvement with this treatment compared to 50% in the IV BP group. The number of patients in whom clinical healing of BRONJ was achieved was statistically better in the oral BP group than in the IV BP group after 6 months of treatment ( P < 0.001). The results showed that >90% of patients treated with oral BPs could be cured. However, 50% of patients treated with IV BPs did not show an improvement. Additional research is needed to further increase the therapeutic efficacy for the resolution of BRONJ.</description><identifier>ISSN: 0901-5027</identifier><identifier>EISSN: 1399-0020</identifier><identifier>DOI: 10.1016/j.ijom.2015.03.013</identifier><identifier>PMID: 25861974</identifier><language>eng</language><publisher>Denmark: Elsevier Ltd</publisher><subject>Administration, Oral ; Aged ; Aged, 80 and over ; Bisphosphonate-Associated Osteonecrosis of the Jaw - pathology ; Bisphosphonate-Associated Osteonecrosis of the Jaw - therapy ; Bone Density Conservation Agents - administration & dosage ; Bone Density Conservation Agents - adverse effects ; BRONJ ; Dentistry ; Diphosphonates - administration & dosage ; Diphosphonates - adverse effects ; Female ; Humans ; Injections, Intravenous ; intravenous bisphosphonate ; Male ; Middle Aged ; oral bisphosphonate ; osteonecrosis ; osteoporosis ; Prognosis ; sequestrectomy ; Surgery ; Treatment Outcome</subject><ispartof>International journal of oral and maxillofacial surgery, 2015-07, Vol.44 (7), p.840-844</ispartof><rights>International Association of Oral and Maxillofacial Surgeons</rights><rights>2015 International Association of Oral and Maxillofacial Surgeons</rights><rights>Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c573t-a97d28c470633fd5b557b98078fc90b65b8bb98a0f5cadef7cbeaf201c150a353</citedby><cites>FETCH-LOGICAL-c573t-a97d28c470633fd5b557b98078fc90b65b8bb98a0f5cadef7cbeaf201c150a353</cites><orcidid>0000-0002-0789-3273</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0901502715001253$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25861974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shintani, T</creatorcontrib><creatorcontrib>Hayashido, Y</creatorcontrib><creatorcontrib>Mukasa, H</creatorcontrib><creatorcontrib>Akagi, E</creatorcontrib><creatorcontrib>Hoshino, M</creatorcontrib><creatorcontrib>Ishida, Y</creatorcontrib><creatorcontrib>Hamana, T</creatorcontrib><creatorcontrib>Okamoto, K</creatorcontrib><creatorcontrib>Kanda, T</creatorcontrib><creatorcontrib>Koizumi, K</creatorcontrib><creatorcontrib>Yoshioka, Y</creatorcontrib><creatorcontrib>Tani, R</creatorcontrib><creatorcontrib>Toratani, S</creatorcontrib><creatorcontrib>Okamoto, T</creatorcontrib><title>Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates</title><title>International journal of oral and maxillofacial surgery</title><addtitle>Int J Oral Maxillofac Surg</addtitle><description>Abstract Bisphosphonates (BPs) have been used in medical practice for the treatment of osteoporosis, bone metastasis, and multiple myeloma. Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study included 59 patients with BRONJ: 29 had taken oral BPs and 30 had taken intravenous (IV) BPs. All received conservative treatments. When separated sequestra were seen, a sequestrectomy was performed. Segmental mandibular resection was performed when pathological fractures were diagnosed. The outcomes of treatments were compared between groups. For patients treated with oral rinses or mandibular resection, the number in whom clinical healing was observed did not differ between the oral BP and IV BP groups. With regard to sequestrectomy, 94% of patients in the oral BP group showed improvement with this treatment compared to 50% in the IV BP group. The number of patients in whom clinical healing of BRONJ was achieved was statistically better in the oral BP group than in the IV BP group after 6 months of treatment ( P < 0.001). The results showed that >90% of patients treated with oral BPs could be cured. However, 50% of patients treated with IV BPs did not show an improvement. Additional research is needed to further increase the therapeutic efficacy for the resolution of BRONJ.</description><subject>Administration, Oral</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bisphosphonate-Associated Osteonecrosis of the Jaw - pathology</subject><subject>Bisphosphonate-Associated Osteonecrosis of the Jaw - therapy</subject><subject>Bone Density Conservation Agents - administration & dosage</subject><subject>Bone Density Conservation Agents - adverse effects</subject><subject>BRONJ</subject><subject>Dentistry</subject><subject>Diphosphonates - administration & dosage</subject><subject>Diphosphonates - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Injections, Intravenous</subject><subject>intravenous bisphosphonate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>oral bisphosphonate</subject><subject>osteonecrosis</subject><subject>osteoporosis</subject><subject>Prognosis</subject><subject>sequestrectomy</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0901-5027</issn><issn>1399-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUGP1SAUhYnROM_RP-DCdOmm9QJDWxJjYl7UmWQSF-qaAL11qC08oZ3JW_jfhbwZF7NwATfAOSfc7xLymkJDgbbvpsZNYWkYUNEAb4DyJ2RHuZQ1AIOnZAcSaC2AdWfkRUoTAEjed8_JGRN9S2V3sSN_9mE56OhS8FUYq_UGq0MMP31ILpUL49LhJpTl9Yp1xDmXoQppxeDRxgddMU76rrJ6S_ndHKsQ9VxpP1TOr1Hfog9behSXXpJno54Tvrqv5-TH50_f95f19dcvV_uP17UVHV9rLbuB9faig5bzcRBGiM7IHrp-tBJMK0xv8lnDKKwecOysQT1mLpYK0Fzwc_L2lJt7-71hWtXiksV51h7ztxRt-1ZKIQTLUnaSlt5SxFEdolt0PCoKqmBXkyrYVcGugKuMPZve3OdvZsHhn-WBcxa8Pwkwd3nrMKpkHXqLg4toVzUE9__8D4_sdnbeWT3_wiOmKWzRZ36KqsQUqG9l8GXueQPKBOd_AfvOrBs</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Shintani, T</creator><creator>Hayashido, Y</creator><creator>Mukasa, H</creator><creator>Akagi, E</creator><creator>Hoshino, M</creator><creator>Ishida, Y</creator><creator>Hamana, T</creator><creator>Okamoto, K</creator><creator>Kanda, T</creator><creator>Koizumi, K</creator><creator>Yoshioka, Y</creator><creator>Tani, R</creator><creator>Toratani, S</creator><creator>Okamoto, T</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0789-3273</orcidid></search><sort><creationdate>20150701</creationdate><title>Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates</title><author>Shintani, T ; Hayashido, Y ; Mukasa, H ; Akagi, E ; Hoshino, M ; Ishida, Y ; Hamana, T ; Okamoto, K ; Kanda, T ; Koizumi, K ; Yoshioka, Y ; Tani, R ; Toratani, S ; Okamoto, T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c573t-a97d28c470633fd5b557b98078fc90b65b8bb98a0f5cadef7cbeaf201c150a353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Administration, Oral</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bisphosphonate-Associated Osteonecrosis of the Jaw - pathology</topic><topic>Bisphosphonate-Associated Osteonecrosis of the Jaw - therapy</topic><topic>Bone Density Conservation Agents - administration & dosage</topic><topic>Bone Density Conservation Agents - adverse effects</topic><topic>BRONJ</topic><topic>Dentistry</topic><topic>Diphosphonates - administration & dosage</topic><topic>Diphosphonates - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Injections, Intravenous</topic><topic>intravenous bisphosphonate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>oral bisphosphonate</topic><topic>osteonecrosis</topic><topic>osteoporosis</topic><topic>Prognosis</topic><topic>sequestrectomy</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shintani, T</creatorcontrib><creatorcontrib>Hayashido, Y</creatorcontrib><creatorcontrib>Mukasa, H</creatorcontrib><creatorcontrib>Akagi, E</creatorcontrib><creatorcontrib>Hoshino, M</creatorcontrib><creatorcontrib>Ishida, Y</creatorcontrib><creatorcontrib>Hamana, T</creatorcontrib><creatorcontrib>Okamoto, K</creatorcontrib><creatorcontrib>Kanda, T</creatorcontrib><creatorcontrib>Koizumi, K</creatorcontrib><creatorcontrib>Yoshioka, Y</creatorcontrib><creatorcontrib>Tani, R</creatorcontrib><creatorcontrib>Toratani, S</creatorcontrib><creatorcontrib>Okamoto, T</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of oral and maxillofacial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shintani, T</au><au>Hayashido, Y</au><au>Mukasa, H</au><au>Akagi, E</au><au>Hoshino, M</au><au>Ishida, Y</au><au>Hamana, T</au><au>Okamoto, K</au><au>Kanda, T</au><au>Koizumi, K</au><au>Yoshioka, Y</au><au>Tani, R</au><au>Toratani, S</au><au>Okamoto, T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates</atitle><jtitle>International journal of oral and maxillofacial surgery</jtitle><addtitle>Int J Oral Maxillofac Surg</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>44</volume><issue>7</issue><spage>840</spage><epage>844</epage><pages>840-844</pages><issn>0901-5027</issn><eissn>1399-0020</eissn><abstract>Abstract Bisphosphonates (BPs) have been used in medical practice for the treatment of osteoporosis, bone metastasis, and multiple myeloma. Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study included 59 patients with BRONJ: 29 had taken oral BPs and 30 had taken intravenous (IV) BPs. All received conservative treatments. When separated sequestra were seen, a sequestrectomy was performed. Segmental mandibular resection was performed when pathological fractures were diagnosed. The outcomes of treatments were compared between groups. For patients treated with oral rinses or mandibular resection, the number in whom clinical healing was observed did not differ between the oral BP and IV BP groups. With regard to sequestrectomy, 94% of patients in the oral BP group showed improvement with this treatment compared to 50% in the IV BP group. The number of patients in whom clinical healing of BRONJ was achieved was statistically better in the oral BP group than in the IV BP group after 6 months of treatment ( P < 0.001). The results showed that >90% of patients treated with oral BPs could be cured. However, 50% of patients treated with IV BPs did not show an improvement. Additional research is needed to further increase the therapeutic efficacy for the resolution of BRONJ.</abstract><cop>Denmark</cop><pub>Elsevier Ltd</pub><pmid>25861974</pmid><doi>10.1016/j.ijom.2015.03.013</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-0789-3273</orcidid></addata></record> |
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| ispartof | International journal of oral and maxillofacial surgery, 2015-07, Vol.44 (7), p.840-844 |
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| subjects | Administration, Oral Aged Aged, 80 and over Bisphosphonate-Associated Osteonecrosis of the Jaw - pathology Bisphosphonate-Associated Osteonecrosis of the Jaw - therapy Bone Density Conservation Agents - administration & dosage Bone Density Conservation Agents - adverse effects BRONJ Dentistry Diphosphonates - administration & dosage Diphosphonates - adverse effects Female Humans Injections, Intravenous intravenous bisphosphonate Male Middle Aged oral bisphosphonate osteonecrosis osteoporosis Prognosis sequestrectomy Surgery Treatment Outcome |
| title | Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates |
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