title: Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates.
abstract: Bisphosphonates (BPs) have been used in medical practice for the treatment of osteoporosis, bone metastasis, and multiple myeloma. Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study included 59 patients with BRONJ: 29 had taken oral BPs and 30 had taken intravenous (IV) BPs. All received conservative treatments. When separated sequestra were seen, a sequestrectomy was performed. Segmental mandibular resection was performed when pathological fractures were diagnosed. The outcomes of treatments were compared between groups. For patients treated with oral rinses or mandibular resection, the number in whom clinical healing was observed did not differ between the oral BP and IV BP groups. With regard to sequestrectomy, 94% of patients in the oral BP group showed improvement with this treatment compared to 50% in the IV BP group. The number of patients in whom clinical healing of BRONJ was achieved was statistically better in the oral BP group than in the IV BP group after 6 months of treatment (P<0.001). The results showed that >90% of patients treated with oral BPs could be cured. However, 50% of patients treated with IV BPs did not show an improvement. Additional research is needed to further increase the therapeutic efficacy for the resolution of BRONJ.
authors: Centre of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan. Electronic address: tshintan@hiroshima-u.ac.jp.
authors: T
authors: T
authors: Shintani
authors: Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors: Y
authors: Y
authors: Hayashido
authors: Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors: H
authors: H
authors: Mukasa
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: E
authors: E
authors: Akagi
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: M
authors: M
authors: Hoshino
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: Y
authors: Y
authors: Ishida
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: T
authors: T
authors: Hamana
authors: Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors: K
authors: K
authors: Okamoto
authors: Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors: T
authors: T
authors: Kanda
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: K
authors: K
authors: Koizumi
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: Y
authors: Y
authors: Yoshioka
authors: Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors: R
authors: R
authors: Tani
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: S
authors: S
authors: Toratani
authors: Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors: T
authors: T
authors: Okamoto
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000473:pathology / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: BRONJ; intravenous bisphosphonate; oral bisphosphonate; osteonecrosis; osteoporosis; sequestrectomy