Prevalence of medication-related osteonecrosis of the jaws in patients treated with intravenous bisphosphonates: an epidemiologic analysis at Centro del Cáncer - Red de Salud UC-CHRISTUS

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Cristián Teuber L.
Camila Foncea R.
Francisco Rojas C.
Kristine von Bischhoffshausen P.
Ignacio Goñi E.
Álex Vargas D.
Hernán Ramírez S.

Keywords

bisphosphonates, zoledronic acid, pamidronate, osteonecrosis of the jaw

Abstract

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a disease involving exposition of necrotic maxillary and mandibular bone and it’s related to antiresorptive and antiangiogenic drugs, with a prevalence that variates from 0,94%-13% in oncologic and osteoporosis patients treated with them. Aim: To determine the prevalence of MRONJ in patients that underwent treatment with intravenous bisphosphonates (IVBP) at Cen­tro del Cancer de la Red de Salud UC-CHRISTUS of Santiago, Chile. Material and Me- thod: Data from patients who received intravenous bisphosphonate treatment between March and September 2016 were analyzed, with follow-ups by their treating teams. Data extraction considered gender, age, primary diagnosis, intravenous bisphosphonate used, fo- llow up time, bone metastases and diagnosis of MRONJ. Results: A sample of  patients was obtained with a men:women ratio of 1:2; an average age of 63,2 years, 78% of the patients were treated with zoledronic acid and 22% of the patients with pamidronate. From the total number of patients,1.4% (n = 2) developed MRONJ, both cases had breast cancer as primary diagnosis and in treatment with zoledronic acid, which corresponds to 1.8% of patients being treated with this drug. Conclusion: Although MRONJ is an infrequent disease, it presents high morbidity and complex management. Prevention and treatment of odontogenic infectious foci in patients before, during and after treatment with IVBP drugs is fundamental to prevent this pathology.

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