Comorbid Conditions are a Risk for Osteonecrosis of the Jaw Unrelated to Antiresorptive Therapy

Publication date: Available online 5 October 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Kenneth E. Fleisher, Malvin N. Janal, Nicole Albstein, James Young, Vanessa Bikhazi, Shlomit Schwalb, Mark S. Wolf, Robert S. Glickman

Abstract

Background: Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJ_uat), confounding risk assessment. This study aimed to determine if ONJ_uat is associated with one or more particular comorbidities.

Study Design: Retrospective case-control study for patients with ONJ_uat and delayed healing (DH). Each case was matched for age, gender and location of the ONJ_uat or DH lesion to a control who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking.

Results: 92 patients were identified, 67 (73%) met the criteria for the ONJ_uat and 25 (27%) met the criteria for DH. The most common trigger for ONJ and DH was extraction (50%). The presence of any comorbidity (i.e., at least one) was more prevalent in ONJ_uat than Controls (p= .04), and there were more comorbidities in ONJ_uat and DH patients than Controls [M(SD)= 1.94 (1.2) and 2.0 (1.3) vs 1.26 (.89); both p< .001].

Conclusions: Osteonecrosis of the jaw and delayed healing are not limited to patients with a history of antiresorptive therapy. More comorbidities may signal increased risk for ONJ_uat and DH.

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