This review of the the frequency of osteonecrosis of the jaw in bisphosphonate users undergoing dental interventions included 27 studies. having dental procedures of 2.7% (95%CI: 0.9 to 5.2%) being higher in those having dental extractions 4.1% (95%CI: 1.5 to 7.7%).
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This Cochrane review of interventions for the prevention and treatment of medication-related osteonecrosis of the jaw (MRONJ) identified 5 trials. Three were related to prevention and two to treatment providing limited evidence to support interventions. More high quality studies are needed.
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This Cochrane review of bisphosphonate related osteonecrosis of the jaw only identified one small RCT. The trial compared the use of hyperbaric oxygen (HBO) as an adjunct to standard care. While it suggested a benefit for HBO it was under powered and at high riisk of bias
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Derek Richards presents the top Dental Elf Blogs of 2015. Highlights include eating disorders and oral health, the long awaited Cochrane Review of water fluoridation and the update of the NICE guidance on infective endocarditis.
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Thirteen studies were included in this review of medication related osteonecrosis of the jaw. The majority were case series ( 9) with the risk of osteonecrosis after tooth extraction being higher in those taking IV bisphosphonates ( 3.2% (95% CI: 1.7–4.7%) than those on oral bisphosphonates 0.15% (95% CI: 0.0–0.36%).
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This 2 year long prospective study of new cases of BRONJ presenting at oral surgery, oral medicine, oral and maxillofacial surgery units, and dental hospitals provides a rough estimate of 508–793 new cases/year across the UK.
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Bisphosphonates (BPs) are used for the treatment of a range of bone problems, e.g., osteoporosis, or bone metastases of malignant cancer. In 2003 the condition of bisphosphonate related osteonecrosis of the jaw (BONJ) was reported. The aim of this retrospective cohort study was to estimate the cumulative incidence and risk ratio for ONJ (osteonecrosis of [read the full story…]
Bisphosphonate-related osteonecrosis of the jaw (BONJ) is a recently recognised condition with reports surfacing in 2003. BONJ defined as exposed, necrotic bone in the maxilla or mandible that has persisted for more than eight weeks in patients taking bisphosphonates and where there has been no history of radiation therapy to the jaw. It has been [read the full story…]
The American Dental Association Center for Evidence-Based Dentistry has just completed a critical review of a paper by Migliorati et al published in 2012 which aimed to examine the prevalence of bisphosphonate osteonecrosis (BON) in the cancer population, prevention and treatment protocols, and quality of life issues. This is a growing area of interest but, [read the full story…]
Patients taking bisphosphonates are at increased risk of oral health complications (Bisphosphonate-related Osteonecrosis of the Jaw – BONJ). BONJ is defined as exposed, necrotic bone in the maxilla or mandible that has persisted for more than eight weeks in patients taking bisphosphonates and where there has been no history of radiation therapy to the jaw. Symptoms [read the full story…]
