Impact of bisphosphonate-related osteonecrosis of the jaw on osteoporotic patients after dental extraction

A population-based cohort study

Yi Fang Huang, Chung Ta Chang, Chih Hsin Muo, Chun Hao Tsai, Yu Fu Shen, Ching Zong Wu

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background and Aims: Little is currently known about the risk of developing bisphosphonate-related osteonecrosis of the jaw (BRONJ). This study sought to determine the incidence of BRONJ in osteoporotic patients. We also sought to identify the nature and types of risk factors of osteonecrosis of jaw (ONJ) related to the use of oral bisphosphonates (BPs). Materials and Methods: Data from the National Health Insurance system of Taiwan. This cohort study included 19,399 adult osteoporosis patients received dental extraction in 2000-2010 (osteoporosis cohort) and 38,669 age and gender matched comparisons selected from dental extraction people without osteoporosis and osteonecrosis history (comparison cohort). All study subjects were followed from the date of their dental extraction (index date) to the development of ONJ and were included in the study up to 2011 or were lost to the study, whichever occurred first. Cox proportional hazard regression was used to estimate the hazard ratio and 95% confidence intervals for the two cohorts. Results: Patients with osteoporosis had a significantly higher risk to develop ONJ than healthy persons (adjusted HR, 2.05; 95% confidence interval, 1.58-2.65). The risk of ONJ increased with the severity of osteoporosis, no matter whether patient with cancer or not. A cumulative effect of dental extraction frequency may increase the risk of ONJ. Conclusions: We concluded that ONJ is caused by a number of factors. Osteoporosis and past dental history play the very important roles, while BPs play the synergistic effect.

Original languageEnglish
Article numbere0120756
JournalPLoS One
Volume10
Issue number4
DOIs
Publication statusPublished - Apr 16 2015

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Bisphosphonate-Associated Osteonecrosis of the Jaw
Tooth Extraction
Osteonecrosis
Diphosphonates
cohort studies
jaws
Jaw
osteoporosis
teeth
Cohort Studies
Osteoporosis
Population
Hazards
Health insurance
confidence interval
Confidence Intervals
health insurance
National Health Programs
history
Taiwan

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Impact of bisphosphonate-related osteonecrosis of the jaw on osteoporotic patients after dental extraction : A population-based cohort study. / Huang, Yi Fang; Chang, Chung Ta; Muo, Chih Hsin; Tsai, Chun Hao; Shen, Yu Fu; Wu, Ching Zong.

In: PLoS One, Vol. 10, No. 4, e0120756, 16.04.2015.

Research output: Contribution to journalArticle

Huang, Yi Fang ; Chang, Chung Ta ; Muo, Chih Hsin ; Tsai, Chun Hao ; Shen, Yu Fu ; Wu, Ching Zong. / Impact of bisphosphonate-related osteonecrosis of the jaw on osteoporotic patients after dental extraction : A population-based cohort study. In: PLoS One. 2015 ; Vol. 10, No. 4.
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