title: Do measurements of inflammatory mediators in blood predict recurrence in patients with bisphosphonate-related osteonecrosis of the jaws?
abstract: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is well-recognised, difficult to manage, and often recurs. The aim of this study was to examine the value of preoperative measurements of inflammatory mediators in blood in 212 patients with BRONJ who were studied prospectively. Multiple logistic regression analysis was used to assess the importance of the amounts of substances in the blood that are independently associated with the dependent variable "recurrence of BRONJ". The only factor that significantly influenced the development of recurrent BRONJ was reduction in the white cell count (p<0.0001; hazard ratio 5.324; 95% CI 2.373 to 11.945). Neither white cell counts nor C-reactive protein concentrations within or above the reference ranges were significantly associated with recurrent BRONJ. Patients whose white cell counts were lower than the reference range were at increased risk of recurrent BRONJ. This may be a marker of reduced immunocompetence, and additional prophylactic measures or treatment should be considered for these patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany. Electronic address: th.mucke@gmx.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Jung
authors.affiliation: Bradford Teaching Hospitals NHS Foundation Trust, Maxillofacial Unit, St. Lukes Hospital, Bradford, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Mitchell
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Stockmann
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors.forename: Marco Rainer
authors.initials: MR
authors.lastname: Kesting
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Munich, Germany.
authors.forename: Herbert
authors.initials: H
authors.lastname: Deppe
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D004164:Diphosphonates / Q000009:adverse effects; D006801:Humans; D018836:Inflammation Mediators; D007568:Jaw
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D018836:Inflammation Mediators
keywords: Bisphosphonates; Blood measures; Jaws; Osteonecrosis; Recurrence; Treatment outcome