title: Potential significance of antiestrogen therapy in the development of bisphosphonate related osteonecrosis of the jaw.
abstract: OBJECTIVE
  There are known risk factors and established treatment protocols for bisphosphonate-related osteonecrosis of the jaw (BRONJ), but it remains a difficult disease to treat, with the risk of relapses. This study investigates whether or not there is a relationship between antiestrogen therapy and BRONJ.
  
  
  METHODS
  In our prospective study, we followed up 93 patients with BRONJ who were seen at our clinic between 2006 and 2011.
  
  
  RESULTS
  We found that breast cancer patients had a significantly worse prognosis than patients with other underlying illnesses (p < 0.01), which might indicate the role of antiestrogen therapy (p < 0.001) as a causative factor.
  
  
  CONCLUSIONS
  The dominance of the female gender among BRONJ patients as well as our new findings related to antiestrogen therapy of breast cancer raise the possibility that estrogen deficiency might be a newly discovered risk factor for BRONJ.
authors.affiliation: Dept. of Oral and Maxillofacial Surgery, Semmelweis University, H-1085 Budapest, Hungary. Electronic address: mvaszilko@gmail.com.
authors.forename: Mihaly
authors.initials: M
authors.lastname: Vaszilko
authors.affiliation: Dept. of Oral and Maxillofacial Surgery, Semmelweis University, H-1085 Budapest, Hungary.
authors.forename: Evelin
authors.initials: E
authors.lastname: Kovacs
authors.affiliation: Dept. of Oral and Maxillofacial Surgery, Semmelweis University, H-1085 Budapest, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Restar
authors.affiliation: 1st Department of Medicine, Semmelweis University, H-1083 Budapest, Korányi S. u. 2/a, Hungary.
authors.forename: Bernadett
authors.initials: B
authors.lastname: Balla
authors.affiliation: Medical Centre, Hungarian Defence Forces, Dept. of Oral and Maxillofacial Surgery, Robert Karoly krt. 44, H-1134 Budapest, Hungary.
authors.forename: Krisztina
authors.initials: K
authors.lastname: Cseplo
authors.affiliation: 1st Department of Medicine, Semmelweis University, H-1083 Budapest, Korányi S. u. 2/a, Hungary.
authors.forename: Janos
authors.initials: J
authors.lastname: Kosa
authors.affiliation: 1st Department of Medicine, Semmelweis University, H-1083 Budapest, Korányi S. u. 2/a, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Lakatos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology* / Q000601:surgery; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010024:Osteoporosis / Q000188:drug therapy; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D050071:Bone Density Conservation Agents; D020847:Estrogen Receptor Modulators
keywords: Antiestrogen therapy; Bisphosphonate; Breast cancer; Estrogen deficiency; Jaw; Osteonecrosis