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Use of the Operant Orofacial Pain Assessment Device (OPAD) to Measure Changes in Nociceptive Behavior
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Published on: June 10, 2013

ONJ in two dental practice-based research network regions.

J L Fellows1, D B Rindal, A Barasch

  • 1Kaiser Permanente Center for Health Research, 3800 N Interstate Ave, Portland, OR 97227, USA. jeffrey.fellows@kpchr.org

Journal of Dental Research
|February 15, 2011
PubMed
Summary

Osteonecrosis of the jaw (ONJ) is rare, but oral bisphosphonates may increase risk. This study found a low absolute risk of ONJ, even with bisphosphonate exposure, highlighting the need for more research.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Pharmacovigilance
  • Dental Public Health

Background:

  • Osteonecrosis of the jaw (ONJ) is a rare condition with poorly defined population incidence.
  • Potential risk factors include bisphosphonate and steroid treatments, osteoporosis, and head/neck radiation therapy.

Purpose of the Study:

  • To estimate the incidence of osteonecrosis of the jaw (ONJ) in a large patient population.
  • To determine the odds ratios for ONJ associated with oral bisphosphonate exposure and other risk factors.

Main Methods:

  • A Dental Practice-Based Research Network study utilized keyword searches and manual chart reviews of electronic health records.
  • The study included adults aged 35 years and older enrolled between 1995 and 2006 in two large healthcare organizations.
  • Data from dental plan resources were also incorporated to identify additional cases.

Main Results:

  • A total of 23 ONJ cases were identified, equating to an incidence of 0.63 per 100,000 patient-years.
  • Eighty-seven percent of ONJ cases had at least one identified risk factor.
  • Six cases (26%) involved patients who had received oral bisphosphonates, who were 15.5 times more likely to develop ONJ than non-exposed patients.

Conclusions:

  • While oral bisphosphonate use was associated with a higher likelihood of ONJ, the absolute risk remains low due to the sparse number of cases.
  • Further research is warranted to establish firmer conclusions regarding the association between oral bisphosphonates and ONJ incidence.