ArticleClinical oral investigations2013
Incidence of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients taking bisphosphonates for osteoporosis treatment - a grossly underestimated risk?
Article in Clinical oral investigations, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Pooled it
- Long-term oral bisphosphonates delay healing after tooth extraction: a single institutional prospective study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Trial
- Clinical efficacy analysis of mucoperiosteal flap combined with perforation technique for tooth extraction in medication-related osteonecrosis of the jaw risk population: a retrospective study.BMC oral health · 2025Article
- What is the appropriate antibiotic administration to prevent MRONJ development after tooth extraction?Journal of bone and mineral metabolism · 2025Article
- Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients.Nature communications · 2025Article
- Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Medication-Related Osteonecrosis of the Jaw in Dental Practice: A Retrospective Analysis of Data from the Milan Cohort.Dentistry journal · 2022Article
- Medication-Related Osteonecrosis of the Jaw (MRONJ): A Review of Pathophysiology, Risk Factors, Preventive Measures and Treatment Strategies.The Saudi dental journal · 2022Review
- Real-world study of antiresorptive-related osteonecrosis of jaw based on the US food and drug administration adverse event reporting system database.Frontiers in pharmacology · 2022Article
- Alendronate and omeprazole in combination reduce angiogenic and growth signals from osteoblasts.Bone reports · 2021Article
- Extensive protein expression changes induced by pamidronate in RAW 264.7 cells as determined by IP-HPLC.PeerJ · 2020Article
- Three-dimensional bone evaluation after surgical treatment with plasma rich in growth factors of Medication Related Osteonecrosis of the Jaw (MRONJ): A report of 3 cases.Bone reports · 2019Article
- The influence of alendronate and tooth extraction on the incidence of osteonecrosis of the jaw among osteoporotic subjects.PloS one · 2018Article
- Risk factors of osteonecrosis of the jaw after tooth extraction in osteoporotic patients on oral bisphosphonates.Imaging science in dentistry · 2017Article
- In vitro comparison of new bisphosphonic acids and zoledronate effects on human gingival fibroblasts viability, inflammation and matrix turnover.Clinical oral investigations · 2016Article
- Initial changes in alveolar bone volume for sham-operated and ovariectomized rats in ligature-induced experimental periodontitis.Clinical oral investigations · 2016Article
- Osteonecrosis of the jaw (ONJ) in renal cell cancer patients after treatment including zoledronic acid or denosumab.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2014Article
- Does regular zoledronic acid change the bone turnover of the jaw in men with metastatic prostate cancer: a possible clue to the pathogenesis of bisphosphonate related osteonecrosis of the jaw?Journal of cancer research and clinical oncology · 2014Article
- Periodontal disease in Paget's disease of bone.Clinical cases in mineral and bone metabolism : the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal DiseasesArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to detect the incidence of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in association with osteoporosis in 2009 in the rural district of Marburg-Biedenkopf, Germany. In addition, the therapeutic regimen of dentists in this area was compared to the treatment guidelines of established international associations. METHODOLOGY: A postal survey including 129 dental offices within the named investigation area was conducted. Additionally, the dentists were asked to contribute to this study during a course of retraining. Ultimately, 107 colleagues participated in this study.
resultsA total of 37 BRONJ cases were revealed, 37.4 % of those were linked to malignant diseases, 62.6 % to osteoporosis. Noticeably, 30.1 % of the BRONJ cases linked to osteoporosis were connected with intravenous application. In total, 62.6 % of all cases were associated with intravenous and 37.4 % with oral application. Considering the estimated number of 1.014 patients using bisphosphonates for osteoporosis treatment in Marburg-Biedenkopf in 2009, the specific incidence of BRONJ could be narrowed down to about 2.27 %. In proportion to the increasing risk potential of the three patient groups, participants conducted fewer surgical interventions themselves but tended to refer patients to colleagues.
conclusionThis study reveals the incidence of BRONJ in association with osteoporosis as being grossly underrated so far, especially in connection with intravenous bisphosphonate treatment. The therapeutic regimen of the dentists who participated correlated with the established guidelines. CLINICAL RELEVANCE: The interface between dentistry and medicine may profit from our study's results which will help to improve interdisciplinary communication. With regard to this, we wish to contribute to an informative discussion since a main focus was to ensure colleagues in their decision making, especially in case of complications after elective dentoalveolar surgery-like implantations. Besides medical there are also economic and political aspects, i.e. the financial responsibility in case of unexpected or inevitable complications, possibly leading to BRONJ, that may become part of future discussions based on this study.
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