Basic and patient-oriented researchNature and Frequency of Bisphosphonate-Associated Osteonecrosis of the Jaws in Australia
Section snippets
Materials and Methods
A 2-page survey form with a reply-paid envelope was sent to all of the Australian members of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZAOMS). The cover letter indicated the reasons for the survey and gave recipients the options of not participating, simply giving the number of ONJ cases that they had treated, or providing details of the cases treated. A working definition of ONJ is an area of exposed bone in the jawbones that fails to heal within 6 weeks
Results
One hundred thirteen questionnaires were mailed to all of the clinically active members of ANZAOMS, with 94 (83%) responding. One hundred and three cases of ONJ were identified with completed questionnaires being provided for 78 cases. Many questionnaires were incomplete. Hence the variable n numbers reported in the tables. The survey was completed in September 2005. Only a few cases were reported to occur before September 2003, hence the study period was 2 years. A further 6 cases were
Discussion
This study shows that bisphosphonate-associated ONJ is a recent and severe condition in Australia. Given the increasing frequency of osteoporosis as the population of Australia progressively ages then the use of oral bisphosphonates is likely to increase. Similarly the bisphosphonates have been shown to be an effective drug in the management of bone malignancy. ONJ is an ongoing and probably increasing challenge that needs to be understood and strategies developed to prevent its occurrence.
The
Acknowledgments
The authors thank members of ANZAOMS for their assistance in responding to the questionnaire and to ADRAC for the data they generously shared. The statistical advice of Dr D. Brennan and Professor A.J. Spencer, The University of Adelaide, is acknowledged. The constructive criticism and assistance of multiple bone metabolic, oncology, pharmaceutical, and dental colleagues, both within Australia and globally, are acknowledged.
References (39)
- et al.
Osteonecrosis of the jaws associated with cancer chemotherapy
J Oral Maxillofac Surg
(2003) Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic
J Oral Maxillofac Surg
(2003)Bisphosphonates and bone necrosis
J Oral Maxillofac Surg
(2004)- et al.
Osteonecrosis of the jaws associated with the use of bisphosphonates: A review of 63 cases
J Oral Maxillofac Surg
(2004) - et al.
Severe osteomyelitis of the jaw in long-term survivors of multiple myeloma: A new clinical entity
Am J Med
(2004) - et al.
Bisphosphonate osteochemonecrosis (bis-phossy jaw): Is this phossy jaw of the 21st century?
J Oral Maxillofac Surg
(2005) - et al.
Bisphosphonate induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: Risk factors, recognition, prevention and treatment
J Oral Maxillofac Surg
(2005) - et al.
Bisphosphonates: From the laboratory to the clinic and back again
Bone
(1999) - et al.
Managing the care of patients with bisphosphonate-associated osteonecrosis
J Am Dent Assoc
(2005) - et al.
Avascular necrosis of the jaws: risk factors in metastatic cancer patients
J Oral Maxillofac Surg
(2003)
Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones
Int J Oral Maxillofac Surg
Practice patterns of oral and maxillofacial surgeons in Australia: 1990 and 2000
Int J Oral Maxillofac Surg
Bisphosphonates and oral cavity avascular bone necrosis
J Clin Oncol
Bisphosphonates and avascular necrosis of the jaw: A possible association
Med J Aust
ADRAC report: Bisphosphonates and osteonecrosis of the jaws
Med J Aust
Avascular jaw necrosis in association with cancer chemotherapy: Series of 10 cases
J Oral Path Med
Osteonecrosis of the jaw and bisphosphonates
N Engl J Med
Mund Kiefer Gesichtschir
Osteonecrosis of the jaw and bisphosphonatesLetter to the editor
N Engl J Med
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Professor Goss has acted as a consultant to Novartis (International and Australia) and to Merck (International and Australia). Dr A. Mavrokokki has acted as a consultant to Novartis (Australia) and Dr A. Cheng to Merck (Australia).