Bisphosphonate-related osteonecrosis of the jaws: analysis of a case series at a dental school

Mathias Duarte, L. F. S., dos Reis, H. B., Tucci, R. and Dib, L. L. (2013), Bisphosphonate-related osteonecrosis of the jaws: analysis of a case series at a dental school. Special Care in Dentistry. doi: 10.1111/scd.12023

ABSTRACT

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is an adverse effect of drugs used to treat bone metabolism diseases, such as osteoporosis and bone metastases. The present study retrospectively evaluated the clinical characteristics and evolution of BRONJ cases that were diagnosed and treated at a dental school from 2004 to 2011. During that period, 13 patients met the criteria of the study among a population of 2,342 patients with oral lesions. Of the 13 patients, 12 were females. Ten were intravenous bisphosphonate users, and nine had breast cancer as the primary disease. Eight mandibular cases were observed. Eight patients interrupted the use of the bisphosphonates temporarily during the treatment. Surgical treatment was conducted in 10 patients, which was associated with platelet-rich plasma in six cases, which led to a regression to Stage I in 50% of these and cure in 33.3%. Of the total sample, four (30.8%) cases were cured, six (46.1%) regressed to Stage I, and three (23.1%) remained in Stage II after treatment. Dental rehabilitation occurred in seven patients. Dissemination of knowledge among professionals is essential for prevention and early diagnosis of BRONJ. Dental schools must act as reference centers and participate in the multidisciplinary care of bisphosphonate users.