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Related Experiment Video

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Use of the Operant Orofacial Pain Assessment Device (OPAD) to Measure Changes in Nociceptive Behavior
12:20

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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, Portland, OR, USA. jeffrey.fellows@kpchr.org

Texas Dental Journal
|June 18, 2013
PubMed
Summary

Osteonecrosis of the jaw (ONJ) is rare, but oral bisphosphonates may increase risk. While patients on these drugs were more likely to develop ONJ, the absolute risk remains low.

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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.