Osteomylelitis and necrosis of the jaw in patients treated with bisphosphonates: a comparative study focused on multiple myeloma.
It was reported that multiple myeloma (MM)-patients suffer from a higher incidence of osteomyelitis and necrosis of the jaws than patients treated with bisphosphonates for other reasons. The aim of this study is to report about 57 cases of bisphosphonate-related osteomyelitis and necrosis of the jaws (BON) and to investigate the differences between BON in MM and non-MM patients. Clinical and laboratory data of 57 cases were assessed. The features of BON and clinical-outcome were compared between the two groups. Treatment approach was assessed as a contributing-factor to treatment-outcome. Clinical presentation included exposed bone, pain, swelling and suppuration with little variation between the two groups. Past dento-alveolar surgery was common in both study-groups. Treatment outcome was poor (33% and 25% responded to treatment in MM group and non-MM group, respectively). Treatment modality did not affect the treatment outcome. The clinical presentation described in this case series should alert the physician to the possibility of BON. Although the literature shows a higher incidence of BON in MM patients compared to non-MM patients, our study suggests that the severity of the clinical presentation and the response to treatment are not worse in MM patients compared with non-MM patients. The predisposition of MM patients to BON should be further investigated.
Elad
S
S
Department of Oral Medicine, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel. eladhome@md.huji.ac.il
Yarom
N
N
Hamed
W
W
Ayalon
S
S
Yahalom
R
R
Regev
E
E
D000368:Aged; D015331:Cohort Studies; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007568:Jaw / Q000473:pathology*; D007571:Jaw Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D009336:Necrosis / Q000139:chemically induced / Q000188:drug therapy / Q000601:surgery; D010019:Osteomyelitis / Q000139:chemically induced* / Q000188:drug therapy / Q000601:surgery; D012307:Risk Factors
D004164:Diphosphonates