A follow-up survey of 30 cases of bisphosphonate-related ostemyelitis/ osteonecrosis of the jaws: present status after 2 years

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  • URADE Masahiro
    Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine
  • TANAKA Noriaki
    Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine
  • SHIMADA Jun
    Division of First Oral and Maxillofacial Surgery, Department of Diagnosis and Therapeutics, Meikai University School of Dentistry
  • SHIBATA Takanori
    Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Human Biology and Pathophysiology, School of Dentistry, Health Science University of Hokkaido
  • FURUSAWA Kiyofumi
    Department of Oral and Maxillofacial Surgery, Matsumoto Dental University
  • KIRITA Tadaaki
    Department of Oral and Maxillofacial Surgery, Nara Medical University
  • YAMAMOTO Tetsuya
    Department of Oral and Maxillofacial Surgery, Kochi Medical School
  • IKEBE Tetsuro
    Oral & Maxillofacial Surgery, Fukuoka Dental College
  • KITAGAWA Yoshimasa
    Department of Oral Diagnosis and Oral Medicine, Division of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University
  • KURASHINA Kenji
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
  • SETO Kanichi
    JSOMS
  • FUKUDA Jinichi
    JSOMS

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Other Title
  • ビスフォスフォネート投与と関連性があると考えられた顎骨骨髄炎ならびに顎骨壊死 30 症例に関する追跡調査〜2年後の現状について〜
  • ビスフォスフォネート トウヨ ト カンレンセイ ガ アル ト カンガエラレタ ガクコツ コツズイエン ナラビニ ガクコツ エシ 30 ショウレイ ニ カンスル ツイセキ チョウサ 2ネンゴ ノ ゲンジョウ ニ ツイテ

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Bisphosphonates(BPs)were first reported to inhibit bone resorption by Fleisch et al. in 1969. BPs are frequently used to treat bone metastatic carcinoma, hypercalcemia, multiple myeloma, and osteoporosis. However, many cases of BP-related osteonecrosis of the jaws(BRONJ)have been reported in the United States since 2003, and similar cases have also been documented in Japan since 2006. The results of the first nationwide survey of BRONJ in Japan were reported in 2007. The present report is the follow-up survey of the previous one in 2007 and describes the present status of the patients after 2 years. Twenty-eight patients were studied because 2 were ineligible. Because 9 patients were completely cured during this follow-up survey, 17 patients(60.8 %)of all patients were completely cured. Nine(52.9 %)of the 17 patients given intravenous BPs and 7(77.8 %)of the 9 patients given oral BPs were completely cured. Surgical treatments, such as sequestrectomy, curettage, and resection of the jaw bone, were performed in 15(88.2 %)of the 17 cured patients and 7(63.6 %)of the 11 non-cured patients. Antibiotic therapy was given to 14(82.4 %)of the cured patients and all of the non-cured patients. Drug holidays of BPs were taken in 9(52.9 %)of the cured patients and 10(90.9 %)of the non-cured patients. Surgical treatments appeared to be performed at a higher rate in the cured patients than in the non-cured patients. In contrast, conservative treatments were given to more non-cured patients than cured patients. These results suggest that surgical treatments may be useful for BRONJ when given at the appropriate time. In addition, BRONJ was shown to be refractory because only 9 of 17 cases were cured in these 2 years.

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