Treatment protocols of bisphosphonate-related osteonecrosis of the jaws

✍ Scribed by Athanassios Kyrgidis; Georgios Koloutsos; Konstantinos Vahtsevanos

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 48 KB
• Volume: 31
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21148

✦ Synopsis

We read with great interest the article by Wutzl et al, 1 reporting a well-designed prospective study for the treatment of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in a cohort of multiple myeloma, breast cancer, and other diseases in patients.

The authors duly report patients' underlying diseases and also dose schemas administered. However, they do not report any data from the previous dental history of these patients, ie, history of tooth extraction. Recently, we carried out a matched case-control study in patients with breast cancer. 2 In this study, we reported that tooth extraction could pose up to 44 times higher risk for BRONJ development. 2 We also found an almost 5-fold increased risk for BRONJ development among patients with breast cancer under zoledronic acid medication using dentures. The evidence provided from the latter study associated BRONJ with tooth extraction and use of dentures and updated the American Society of Clinical Oncology (ASCO) level of evidence from V to III. 2 Wutzl et al report that 72.7% of their patients received zoledronic acid for the disease. We believe that dental history of the 58 patients is available to Wutzl et al and we look forward to reading these data in a forthcoming publication.

Despite being well designed and original, the study by Wutzl et al also has an important limita-detailed report of our patient cohort will be definitely reported in a forthcoming study.