title: Osteonecrosis of the jaw correlated to bisphosphonate therapy in non-oncologic patients: clinicopathological features of 24 patients.
abstract: OBJECTIVE
  Osteonecrosis of the jaws (ONJ) is a well known side effect of bisphosphonate therapies in patients with multiple myeloma or other malignancies. Its real incidence is still undetermined, and only few cases of ONJ in patients taking bisphosphonates for non-oncologic diseases have been reported. It was postulated that the clinical features, predisposing factors, and treatment outcome of this subset of patients might be different from those of oncologic patients.
  
  
  METHODS
  Over a 4 year period, a total of 102 bisphosphonate-treated patients affected by ONJ were identified. Among these, 24 patients underwent bisphosphonate therapy for non-neoplastic disease and their profile was analyzed.
  
  
  RESULTS
  In this study cohort, bisphosphonates had been administered mainly for postmenopausal osteoporosis (20/24 patients, 83.3%), the duration of therapy until presentation of ONJ ranging from 11 to 40 months and the most common triggering event being dentoalveolar surgery. All patients were nonsmokers; 6 manifested multiple ONJ lesions and only 3 of them had possible comorbidities. Surgical debridement was performed in 19 patients for a total of 22 lesions, which were individually considered in the followup. The latter showed complete remission of ONJ in 21/22 lesions.
  
  
  CONCLUSIONS
  Although it might be considered a rare condition in non-oncologic patients, ONJ is a harmful side effect of bisphosphonate therapies. Clinicians must be aware of this entity, inform patients of the risks related to dental surgery, and possibly undertake adequate preventive measures.
authors.affiliation: Division of Oral Pathology, Department of Odontostomatology and Surgery, University of Bari, Bari, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Favia
authors.forename: Giovanni Pietro
authors.initials: GP
authors.lastname: Pilolli
authors.forename: Eugenio
authors.initials: E
authors.lastname: Maiorano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003729:Dental Care / Q000009:adverse effects; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D010024:Osteoporosis / Q000188:drug therapy
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates