title: Dental risk factors for osteonecrosis of the jaws: a CONDOR case-control study.
abstract: BACKGROUND
  Reports of osteonecrosis of the jaw (ONJ) have associated this lesion to treatment with bisphosphonates (BPs) and dental procedures. In this study, we investigated the association of specific dental diagnoses and procedures with ONJ among patients with past BP use.
  
  
  METHODS
  Dentists from three practice-based research networks provided ONJ cases and controls (1:3). Data gathered from patients and dental offices with two respective standard questionnaires included demographic, medical, pharmaceutical, and dental information. Diagnoses and procedures up to 3 years prior to ONJ (prior to interview for controls) were analyzed within risk strata, defined by BP use and cancer status, using interaction terms within conditional logistic regression models.
  
  
  RESULTS
  We enrolled 191 ONJ cases and 573 controls from 119 dental offices. Among participants who had used only oral BP, extraction was the only dental risk factor for ONJ (odds ratio (OR) = 12, p = 0.01). Suppuration was also more prevalent in cases (18 %) than in controls (9 %), but not statistically significant (OR = 9, p = 0.06). Among participants who had not used either oral or IV BP (a majority of whom received radiation therapy to the head and neck), suppuration was the only dental risk factor for ONJ (prevalence = 34 % for cases and 8 % for controls; OR = 7, p = 0.01). The prevalence of extractions in this group was also higher, but not statistically significant (44 vs 10 %; OR = 3). Limited power precludes definitive findings among participants exposed to IV BP.
  
  
  CONCLUSIONS
  Among patients taking oral BP, extraction was the only dental procedure associated with subsequent ONJ development
  
  
  CONCLUSIONS
  Results of this study suggest that routine dental procedures are not associated with development of ONJ in patients exposed to BPs.
authors.affiliation: Department of Dental Medicine, Winthrop University Hospital, 222 Station Plaza N, Suite 408, Mineola, NY, 11501, USA, abarasch@winthrop.org.
authors.forename: A
authors.initials: A
authors.lastname: Barasch
authors.forename: J
authors.initials: J
authors.lastname: Cunha-Cruz
authors.forename: F
authors.initials: F
authors.lastname: Curro
authors.forename: T
authors.initials: T
authors.lastname: DeRouen
authors.forename: G H
authors.initials: GH
authors.lastname: Gilbert
authors.forename: P
authors.initials: P
authors.lastname: Hujoel
authors.forename: M M
authors.initials: MM
authors.lastname: Safford
authors.forename: D A
authors.initials: DA
authors.lastname: Vena
authors.forename: A E
authors.initials: AE
authors.lastname: Voinea-Griffin
authors.forename: H
authors.initials: H
authors.lastname: Wu
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D006801:Humans; D012307:Risk Factors