Comparison of nonexposed and exposed bisphosphonate-induced osteonecrosis of the jaws: a retrospective analysis from the Copenhagen cohort and a proposal for an updated classification system

Morten Schiodt; Jesper Reibel; Peter Oturai; Thomas Kofod

doi:10.1016/j.oooo.2013.10.010

Comparison of nonexposed and exposed bisphosphonate-induced osteonecrosis of the jaws: a retrospective analysis from the Copenhagen cohort and a proposal for an updated classification system

Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Feb;117(2):204-13. doi: 10.1016/j.oooo.2013.10.010. Epub 2013 Nov 15.

Authors

Morten Schiodt¹, Jesper Reibel², Peter Oturai³, Thomas Kofod⁴

Affiliations

¹ Consultant Oral and Maxillofacial Surgeon, Department of Oral & Maxillofacial Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark. Electronic address: mschioedt@hotmail.com.
² Professor, Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, Department of Odontology, University of Copenhagen, Copenhagen, Denmark.
³ Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
⁴ Head, Consultant Oral and Maxillofacial Surgeon, Department of Oral & Maxillofacial Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.

PMID: 24332520
DOI: 10.1016/j.oooo.2013.10.010

Abstract

Objective: Nonexposed osteonecrosis of the jaws (NE-ONJ) does not fit into the current definition of osteonecrosis, which requires exposed bone. A modification of the classification of bisphosphonate-induced osteonecrosis of the jaws (ONJ) is proposed. This study aimed to test proposed criteria for NE-ONJ and compare NE-ONJ with exposed ONJ (E-ONJ) in a retrospective analysis.

Study design: In 102 patients with E-ONJ diagnosed according to Ruggiero et al. (2006, 2009), criteria for NE-ONJ were developed. Subgroups of NE-ONJ and E-ONJ were tested against each other using nonparametric and parametric statistics.

Results: Among 102 patients with ONJ, 14 had NE-ONJ and 88 had E-ONJ. NE-ONJ and E-ONJ were similar in all important data (P > .05) except bone exposure.

Conclusions: NE-ONJ belongs to the same disease condition as E-ONJ. NE-ONJ may be otherwise classified as ONJ stage 1, 2, or 3 and is different from ONJ stage 0. We propose to include the criteria for NE-ONJ into the classification.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Aged, 80 and over
Bisphosphonate-Associated Osteonecrosis of the Jaw / classification*
Bisphosphonate-Associated Osteonecrosis of the Jaw / epidemiology
Denmark / epidemiology
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors