Letter to the Editor
Editor, – I was very interested in the dental note concerning bone turnover markers (Aust Prescr 2012;35:159). The authors state that the incidence of bisphosphonate-related osteonecrosis of the jaw is 1 in 500 to 1 in 1500. Is this related to oral bisphosphonates used to treat osteoporosis, or does it include intravenous bisphosphonates associated with the treatment of various cancers?
I have recently attended a number of meetings with endocrinologists where they consistently state that the incidence of bisphosphonate-related osteonecrosis of the jaw associated with oral bisphosphonate treatment of osteoporosis is about 1 in 100 000.
There is obviously a wide variation of opinion. I would appreciate comments from the authors regarding this discrepancy on the incidence of osteonecrosis of the jaw.
- Mavrokokki T, Cheng A, Stein B, Goss A. Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. JOral Maxillofac Surg 2007;65:415-23.
- Lo JC, O’Ryan FS, Gordon NP, Yang J, Hui RL, Martin D, et al. Predicting the risk of osteonecrosis of the jaw with oral bisphosphonate exposure. J Oral Maxillofac Surg 2010;68:243-53.
- Yarom N, Yahalom R, Shoshani Y, Hamed W, Regev E, Elad S. Osteonecrosis of the jaw induced by orally administered bisphosphonates: incidence, clinical features, predisposing factors and treatment outcome. Osteoporos Int 2007;18:1363-70.
- Sedghizadeh PP, Stanley K, Caligiuri M, Hofkes S, Lowry B, Shuler CF. Oral bisphosphonate use and prevalence of osteonecrosis of the jaws: an institutional study. J Am Dent Assoc 2009;40:61-6.
- Kunchur R, Need A, Hughes T, Goss A. Clinical investigation of C-terminal cross-linking telopeptide test in prevention and management of bisphosphonate-associated osteonecrosis of the jaws. J Oral Maxillofac Surg 2009;67:1167-73.
- Osteoporosis Australia. Joint Osteoporosis Australia and Australian Dental Association ‘Bisphosphonates and ONJ’ statement (for Dentists). 2010. www.osteoporosis.org.au/health-professionals/research-position-papers/#joint [cited 2013 Mar 6]
- Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. JBone Miner Res 2007;22:1479-91.
- Whitaker M, Guo J, Kehoe T, Benson G. Bisphosphonates for osteoporosis – where do we go from here? N Engl J Med 2012;366:2048-51.