title: Medication-related osteonecrosis of the jaw associated with bisphosphonates and denosumab in osteoporosis.
abstract: OBJECTIVE
  To describe the clinical characteristics and evolution of our series of medication-related osteonecrosis of the jaws (MRONJ) associated with denosumab in osteoporotic patients.
  
  
  METHODS
  We present 10 new cases of MRONJ in patients receiving denosumab for osteoporosis. We describe the mean doses of denosumab, previous bisphosphonate intake, and the clinical characteristics associated with the osteonecrosis, such as local contributing factors, symptoms, and evolution after treatment.
  
  
  RESULTS
  The mean number of denosumab doses was 3.4 ± 2.2. In 90% of patients, there was a prior history of oral bisphosphonate intake, with a mean duration of 46.78 ± 25.11 months. The most common local factor was dental extraction (6 cases; 60%), and most cases had necrotic bone exposure (9/10, 90%). Sclerosis of the bone was the most common radiographic finding. Stage 1 was the most common ONM stage, found in 80%. 'Cure' after conservative treatments was obtained in 71.4%.
  
  
  CONCLUSIONS
  Most of our cases were in the early stages of MRONJ, and the success rate after conservative treatment was high.
authors.affiliation: Oral Medicine, University of Valencia, Valencia, Spain.|Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Bagan
authors.affiliation: Oral Medicine, Valencia University, Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Peydró
authors.affiliation: Rheumatology, University General Hospital, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Calvo
authors.affiliation: Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Leopoldo
authors.affiliation: Oral Medicine, Valencia University, Valencia, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Jiménez
authors.affiliation: Oral Medicine, Universidad Europea Valencia, Valencia, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Bagan
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000000981:diagnostic imaging / Q000209:etiology*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D000069448:Denosumab / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy; D012598:Sclerosis; D014057:Tomography, X-Ray Computed
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000069448:Denosumab
keywords: denosumab; jaw; osteonecrosis; osteoporosis