Osteonecrosis of the Jaw Disease Burden Higher in Patients With Osteoporosis vs Those With Bone Malignancy: Presented at ASBMR

By Frances Morin

ATLANTA -- September 21, 2016 -- Osteonecrosis of the jaw (ONJ) is associated with significantly higher disease burden in patients with osteoporosis compared with those with a bone malignancy, according to a study presented here at the 2016 Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).

“Although ONJ incidence greatly varies with antiresorptive dose, for patients with ONJ the disease burden was higher in the osteoporotic versus oncologic group,” wrote Sotirios Tetradis, PhD, University of California Los Angeles School of Dentistry, Los Angeles, California, and colleagues in their presentation.

For the study, the researchers evaluated the records of 70 patients with ONJ (44 females and 26 males) who had been treated with antiresorptive drugs (bisphosphonates or denosumab).

Of the patients, 29 were being treated for osteoporosis and 41 were being treated for bone malignancy. Those in the osteoporosis group were predominantly female and the oncologic group was more evenly distributed in gender.

Despite having received lower doses of antiresorptive drugs, the patients with osteoporosis showed significantly higher rates of suffering from stage 2 ONJ, compared with oncologic patients, who were more likely to have stage 1 ONJ.

Patients with stage 3 ONJ had increased rates of bone sclerosis, periosteal bone formation, sequestration and osteolysis, with no similar effects seen in stages 1 and 2.

The authors made the unexpected observation of seeing no abnormal radiographic findings in a subset of 20 patients (28.5%), indicating the localisation of bone exposure would not have been feasible without prior knowledge of the clinical presentation.

“This subset included significantly more oncologic patients, more stage 1 ONJ, more frequent localisation to dentate areas, and affected more frequently the lingual cortex of both jaws,” the authors wrote. “Our findings further dissect the spectrum of ONJ presentation in the context of systemic disease and identify a subtype of ONJ patients with unique combination of clinical and radiographic features.”

[Presentation title: Clinical and Radiographic Appearance of ONJ in Patients With Osteoporosis vs Bone Malignancy. Abstract LB-MO0373]

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