Thirteen cases of jaw osteonecrosis in patients on bisphosphonate therapy - 10/01/08
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Abstract |
Introduction |
We report on our experience with 13 cases of jaw osteonecrosis in patients treated with amino-bisphosphonates.
Method |
Data were collected by a regional observatory for jaw osteonecrosis in northern France via letters sent to all physicians likely to manage patients with this condition. All study patients were evaluated at a multidisciplinary jaw osteonecrosis clinic between June and December 2005.
Results |
We identified 13 cases, in 12 women and 1 man, with a mean age of 62.6 years. Intravenous amino-bisphosphonate therapy was given for metastatic bone disease from breast cancer in 7 patients and multiple myeloma in 5 patients; the remaining patient was on oral alendronate for osteoporosis. Mean treatment duration was 24 months. A history of dental extraction was found in 11 (84.6%) patients. The mandible was involved in all 13 patients and the maxillary in 3 (23%) patients. Amino-bisphosphonate therapy was discontinued in all 13 patients. We suggest a classification scheme for the clinical and computed-tomography patterns seen in our patients.
Conclusion |
Jaw osteonecrosis is a severe complication of amino-bisphosphonate therapy. In addition to the application of published guidelines, we propose discontinuing bisphosphonate therapy whenever possible. We are evaluating our classification scheme to identify early diagnostic criteria and/or clinical and computed-tomography outcome criteria that would improve the management of patients with jaw osteonecrosis.
Le texte complet de cet article est disponible en PDF.Keywords : Bisphosphonate, Jaw osteonecrosis, Classification, Vitamin D deficiency, Calcium deficiency
Plan
Vol 75 - N° 1
P. 34-40 - janvier 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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