ONJ in two dental practice-based research network regions

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Public Health
• Pharmacovigilance

Background:

• Osteonecrosis of the jaw (ONJ) is a rare condition with incompletely understood incidence and risk factors.
• Potential risk factors include bisphosphonate therapy, corticosteroid use, osteoporosis, and head/neck radiation.

Purpose of the Study:

• To estimate the incidence of osteonecrosis of the jaw (ONJ) in a large patient population.
• To assess the association between oral bisphosphonate exposure and other potential risk factors with ONJ development.

Main Methods:

• A Dental Practice-Based Research Network study utilized keyword searches and manual chart reviews of electronic health records.
• Data were collected from adults aged 35 years or older enrolled in two large healthcare organizations between 1995 and 2006.
• Additional cases were identified through dental plan resources.

Main Results:

• A total of 23 ONJ cases were identified, yielding an incidence of 0.63 per 100,000 patient-years.
• Eighty-seven percent of ONJ cases had at least one identified risk factor.
• Patients exposed to oral bisphosphonates showed a 15.5-fold increased odds of developing ONJ compared to non-exposed patients, though the number of cases was small.

Conclusions:

• The study suggests that while oral bisphosphonates are associated with an increased odds of ONJ, the absolute risk in the general population is low.
• The limited number of ONJ cases restricts the ability to draw definitive conclusions regarding specific risk factor associations.