title: Bisphosphonate-related osteonecrosis of jaw (BRONJ) in Japanese population: a case series of 13 patients at our clinic.
abstract: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) affects quality of life and is an important problem for dentists. A Japanese position paper on BRONJ was published in 2010. The purpose of this study was to review clinical data on the treatment of BRONJ obtained at the Clinic of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba Hospital to further our understanding of this disease. A total of 13 patients (6 men and 7 women) were included. All the patients included in this study had received Bisphosphonate (BP) therapy and had BRONJ. Five of them (38.5%) had received oral BP therapy for osteoporosis, while the remaining 8 (61.5%) had received parenteral BP therapy for bone metastases from breast or prostate cancer. Osteoporosis patients were treated with risedronate or alendronate. Breast or prostate cancer patients were treated with zoledronate. Two patients with rheumatoid arthritis were treated with corticosteroid. Three patients had diabetes mellitus. Eleven patients were treated with antibiotics, while 5 underwent surgical treatment. Discontinuation of BP was recorded in 7 patients during dental treatment. Sequestration was observed in 6 patients during an 11-month follow-up. Eventually, healing and improvement of the oral mucosa were observed in 3 patients. The current standard treatment for BRONJ does not always provide good results. It is necessary to accumulate further clinical data to establish more effective treatment strategies for BRONJ.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan. tanomura@tdc.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nomura
authors.forename: Takahiko
authors.initials: T
authors.lastname: Shibahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Takeo
authors.initials: T
authors.lastname: Shibui
authors.forename: Takashi
authors.initials: T
authors.lastname: Yakushiji
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Kyotaro
authors.initials: K
authors.lastname: Muramatsu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogane
authors.forename: Masato
authors.initials: M
authors.lastname: Murayama
authors.forename: Riyo
authors.initials: R
authors.lastname: Sekine
authors.forename: Erika
authors.initials: E
authors.lastname: Nakata
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fujimoto
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000008:administration & dosage / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology; D048909:Diabetes Complications; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects; D012968:Etidronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects; D007263:Infusions, Parenteral; D007564:Japan; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D010024:Osteoporosis / Q000188:drug therapy; D011471:Prostatic Neoplasms / Q000473:pathology; D000068296:Risedronic Acid; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D000077211:Zoledronic Acid
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate