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Can children be affected by bisphosphonate-related osteonecrosis of the jaw? A systematic review

Nathália Tuany Duarte1, Bruna de Oliveira Rech1, Isabela Godoy Martins2

  • 1Special Care Dentistry Centre (CAPE), Department of Stomatology of the University of São Paulo School of Dentistry, São Paulo, Brazil; Oral Pathology, Department of Stomatology of the University of São Paulo School of Dentistry, São Paulo, Brazil.

International Journal of Oral and Maxillofacial Surgery
|August 27, 2019
PubMed

Insights

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is rare in children, but studies are limited. Further research is needed to understand the long-term risks in pediatric patients using bisphosphonates for osteoporosis.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Pediatric Endocrinology
  • Pharmacology

Background:

  • Bisphosphonate-related osteonecrosis of the jaw (BRONJ) knowledge primarily stems from adult cases.
  • Bisphosphonates are increasingly used for pediatric osteoporosis, raising concerns about BRONJ risk in this population.

Purpose of the Study:

  • To conduct a literature review on the incidence and risk factors of BRONJ in children and adolescents.
  • To identify gaps in current research regarding pediatric BRONJ.

Main Methods:

  • Systematic search of PubMed, LILACS, Web of Science, Scopus, and Cochrane databases.
  • Inclusion of studies on bisphosphonate use in individuals under 24 years old; exclusion of reviews and case reports.
  • Analysis of seven eligible publications identified from an initial 56.

Main Results:

  • No cases of osteonecrosis of the jaw were identified in the reviewed pediatric studies.
  • All included studies exhibited limitations, including small sample sizes and lack of detailed risk factor analysis.
  • A consensus exists on the need for further investigation into pediatric BRONJ.

Conclusions:

  • While BRONJ appears rare in children, current evidence is insufficient to definitively assess risk.
  • Long-term follow-up of pediatric patients using bisphosphonates into adulthood is recommended.
  • Further high-quality studies are crucial to establish definitive conclusions on pediatric BRONJ.

Keywords:
AdolescentsBisphosphonate-associated osteonecrosis of the jawBisphosphonate-related osteonecrosis of the jawBisphosphonatesChildrenOsteonecrosis

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