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Factors predicting the prognosis of oral alendronate‐related osteonecrosis of the jaws: A 4‐year cohort study
Author(s) -
Lee JangJaer,
Cheng ShihJung,
Wang JaiJen,
Chiang ChunPin,
Chang HaoHueng,
Chen HsinMing,
Kok SangHeng
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23235
Subject(s) - medicine , hazard ratio , confidence interval , osteonecrosis of the jaw , cohort , univariate analysis , multivariate analysis , surgery , dentistry , osteoporosis , bisphosphonate
Background Studies concerning prognostic factors specific for alendronate‐related osteonecrosis of the jaws (ONJ) are rare. Methods We surveyed a cohort of 100 osteoporotic patients with 111 alendronate‐related ONJ lesions treated during a 4‐year period. Prognostic values of clinical variables and serum markers of bone turnover were assessed by univariate and multivariate analyses. Results The cumulative complete response rate at 6 months was 48.65%. Serum bone‐specific alkaline phosphatase (BSAP) level >10 μg/L, lesion depth ≦ 10 mm, and lesions in anterior regions denoted a better chance of healing within 6 months and the adjusted hazard ratios were 2.48 (95% confidence interval [CI], 1.41–4.37), 2.71 (95% CI, 1.57–4.70), and 3.94 (95% CI, 1.87–8.30), respectively. Conclusions Early discovery of lesions and prevention of their deeper extension are crucial for improving the prognosis of alendronate‐related ONJ. A higher pretreatment level of BSAP indicates a better prognosis. © 2013 Wiley Periodicals, Inc. Head Neck 35: 1787–1795, 2013