title: Factors predicting the prognosis of oral alendronate-related osteonecrosis of the jaws: a 4-year cohort study.
abstract: BACKGROUND
  Studies concerning prognostic factors specific for alendronate-related osteonecrosis of the jaws (ONJ) are rare.
  
  
  METHODS
  We surveyed a cohort of 100 osteoporotic patients with 111 alendronate-related ONJ lesions treated during a 4-year period. Prognostic values of clinical variables and serum markers of bone turnover were assessed by univariate and multivariate analyses.
  
  
  RESULTS
  The cumulative complete response rate at 6 months was 48.65%. Serum bone-specific alkaline phosphatase (BSAP) level >10 μg/L, lesion depth ≦ 10 mm, and lesions in anterior regions denoted a better chance of healing within 6 months and the adjusted hazard ratios were 2.48 (95% confidence interval [CI], 1.41-4.37), 2.71 (95% CI, 1.57-4.70), and 3.94 (95% CI, 1.87-8.30), respectively.
  
  
  CONCLUSIONS
  Early discovery of lesions and prevention of their deeper extension are crucial for improving the prognosis of alendronate-related ONJ. A higher pretreatment level of BSAP indicates a better prognosis.
authors.affiliation: School of Dentistry, National Taiwan University Medical Center, Taipei, Taiwan.
authors.forename: Jang-Jaer
authors.initials: JJ
authors.lastname: Lee
authors.forename: Shih-Jung
authors.initials: SJ
authors.lastname: Cheng
authors.forename: Jai-Jen
authors.initials: JJ
authors.lastname: Wang
authors.forename: Chun-Pin
authors.initials: CP
authors.lastname: Chiang
authors.forename: Hao-Hueng
authors.initials: HH
authors.lastname: Chang
authors.forename: Hsin-Ming
authors.initials: HM
authors.lastname: Chen
authors.forename: Sang-Heng
authors.initials: SH
authors.lastname: Kok
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000009:adverse effects*; D000469:Alkaline Phosphatase / Q000097:blood; D000658:Amoxicillin / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000473:pathology / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D016723:Bone Remodeling; D002710:Chlorhexidine / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D015331:Cohort Studies; D024042:Collagen Type I / Q000097:blood; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000188:drug therapy; D010455:Peptides / Q000097:blood; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D009067:Mouthwashes; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D002981:Clindamycin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D000469:Alkaline Phosphatase; D002710:Chlorhexidine; D019386:Alendronate
keywords: BSAP; CTX; ONJ; alendronate; osteoporosis