Table 1.
Reported cases of bisphosphonate-induced osteonecrosis of the jaws
| Reference | Patients, n | Gender, n | Age | Site, n | BP medication (n) | Primary diagnosis (n) | Treatment (n) | |||
|---|---|---|---|---|---|---|---|---|---|---|
| M | F | Mandible | Maxilla | Both | ||||||
| Diego [28] | 10 | 6 | 4 | 58–71 | 8 | 12 | ZA (10) | Multiple myeloma (3) | ABs; debridement (7) | |
| Breast carcinoma (1) | ABs; maxillectomy (2) | |||||||||
| Lung carcinoma (4) | Mandibular resection (1) | |||||||||
| Prostate carcinoma (2) | ||||||||||
| Magopoulos [29] | 60 | 28 | 32 | 47–76 | 30 | 22 | 8 | P; ZA (24) | Multiple myeloma (32) | Cessation of BP; ABs; surgery (9) |
| P; ZA; I (3) | Breast carcinoma (18) | HBO; ABs; surgery (6) | ||||||||
| ZA (33) | Lung carcinoma (2) | Cessation of BP; ABs (24) | ||||||||
| Prostate carcinoma (5) | ABs (11) | |||||||||
| Neuroendocrine carcinoma (1) | ABs; surgery (10) | |||||||||
| Fibrous dysplasia (1) | ||||||||||
| Amyloidosis (1) | ||||||||||
| Clarke [30] | 25 | 15 | 10 | 41–80 | 19 | 6 | P (10) | Multiple Myeloma (20) | Medical (12); +HBO (3) | |
| P; ZA (8) | Breast carcinoma (1) | Medical; surgical, not specified (10) | ||||||||
| ZA (5) | Prostate carcinoma (1) | Not specified (2) | ||||||||
| Metastatic lymphoma (1) | No treatment (1) | |||||||||
| Osteoporosis (1) | ||||||||||
| Mortensen [31] | 7 | 3 | 5 | 61–76 | 3 | 4 | P (3) | Multiple myeloma (4) | Maxillectomy; zygoma resection (1) | |
| ZA (4) | Breast carcinoma (3) | Partial maxillectomy (2) | ||||||||
| ABs; debridement; sequestrectomy (3) | ||||||||||
| Not specified (1) | ||||||||||
| Brooks [23] | 2 | 2 | 62; 70 | 1 | 1 | Risedronate (2) | Osteoporosis (2) | ABs; sequestrectomy (1) | ||
| ABs (1) | ||||||||||
| Rossi [32] | 10 | 6 | 4 | 64, mean | 7 | 2 | 1 | ZA (10) | Not specified | Debridement (7) |
| Partial maxillectomy (2) | ||||||||||
| Mandibular resection (1) | ||||||||||
| Dimitrakopoulos [4] | 11 | 5 | 6 | 47–76 | 7 | 3 | 1 | P; ZA (4) | Multiple myeloma (5) | Debridement (1) |
| ZA (6) | Breast carcinoma; lung carcinoma (1) | Sequestrectomy (3) | ||||||||
| P; ZA; I (1) | Prostate carcinoma (2) | Medical (2) | ||||||||
| Osteoporosis (1) | ||||||||||
| Neuroendocrine carcinoma (1) | ||||||||||
| Fibrous dysplasia (1) | ||||||||||
| Merigo [33] | 29 | 4 | 21 | 45–83 | 20 | 7 | 2 | P (11) | Multiple myeloma (12) | Medical; surgical; Nd:YAG biostimulation |
| ZA (15) | Breast carcinoma (12) | |||||||||
| A (3) | Prostate carcinoma (1) | |||||||||
| Osteoporosis (3) | ||||||||||
| Pleural mesothelioma (1) | ||||||||||
| Zarychanski [12] | 12 | 7 | 5 | 10 | 1 | 1 | P (12) | Multiple myeloma (10) | ||
| Breast carcinoma (1) | ||||||||||
| Renal carcinoma (1) | ||||||||||
| Bamias [34] | 17 | 10 | 7 | 43–72 | 14 | 3 | P; ZA (9) | Multiple myeloma (11) | Cessation of BP; ABs; oral rinses; minor debridement; HBO | |
| ZA (7) | Breast carcinoma (2) | |||||||||
| ZA; I (1) | Prostate carcinoma (3) | |||||||||
| Other neoplasm (1) | ||||||||||
| Bagan [35] | 20 | 5 | 15 | 36–80 | 11 | 1 | 8 | P (5) | Multiple myeloma (9) | ABs; minor surgery; bone resection; free grafts; microvascular surgery |
| P; ZA (6) | Breast carcinoma (10) | |||||||||
| ZA (9) | Prostate carcinoma (1) | |||||||||
| Bagan [36] | 10 | 2 | 8 | 36–80 | 5 | 5 | P (4) | Multiple myeloma (4) | Not specified | |
| P; ZA (4) | Breast carcinoma (6) | |||||||||
| ZA (2) | ||||||||||
| Cheng [11] | 5 | 3 | 2 | 57–84 | 4 | 1 | P (4) | Not specified | HBO; maxillectomy (1) | |
| A (1) | Local debridement; sequestrectomy (1) | |||||||||
| Local debridement ; HBO (1) | ||||||||||
| Partial maxillectomy (1) | ||||||||||
| Miglioratti [37] | 18 | 4 | 14 | 37–74 | P; ZA | Multiple myeloma (3) | Debridement (1) | |||
| Not specified | Not specified | Breast carcinoma (10) | ABs; bone smoothening (1) | |||||||
| Prostate carcinoma (2) | ABs; rinses (1) | |||||||||
| Ovarian carcinoma (1) | ABs; sequestrectomy (14) | |||||||||
| Ovarian; breast carcinoma (1) | ABs; sequestrectomy; HBO (1) | |||||||||
| Osteopenia (1) | ||||||||||
| Melo [38] | 11 | 7 | 4 | 59–83 | 8 | 2 | 1 | P (4) | Multiple myeloma (7) | Sequestrectomy (6) |
| P; ZA (3) | Breast carcinoma (3) | Partial mandibulectomy (1) | ||||||||
| ZA (4) | Lung carcinoma (1) | Partial maxillectomy (1) | ||||||||
| Conservative treatment (3) | ||||||||||
| Pires [39] | 14 | 4 | 10 | 43–84 | 9 | 4 | 1 | P (4) | Multiple myeloma (6) | ABs; debridement (11) |
| P; ZA (5) | Breast carcinoma (6) | ABs (3) | ||||||||
| ZA (3) | Lung carcinoma (1) | |||||||||
| Not specified | Prostate carcinoma (1) | |||||||||
| Carter [26] | 5 | 3 | 2 | 57–84 | 4 | 1 | P (4) | Multiple myeloma (2) | Cessation of BP (5) | |
| A (1) | Paget’s disease (3) | Local debridement (3) | ||||||||
| HBO (2) | ||||||||||
| Sequestrectomy (1) | ||||||||||
| Wide excision (1) | ||||||||||
| Le Fort 1 maxillectomy (1) | ||||||||||
| Purcell [27] | 13 | 7 | 6 | 42–83 | 4 | 2 | P (2) | Multiple myeloma (3) | ||
| Not specified | P; ZA (1) | Breast carcinoma (5) | ||||||||
| ZA (9) | Prostate carcinoma (4) | |||||||||
| A (1) | Osteoporosis (1) | |||||||||
| Marx [22] | 119 | 81 | 33 | 5 | P (32) | Multiple myeloma (62) | Cessation of BP; debridement; HBO; ABs; surgery | |||
| P; ZA (36) | Breast carcinoma (50) | |||||||||
| ZA (48) | Prostate carcinoma (4) | |||||||||
| A (3) | Osteoporosis (3) | |||||||||
| Ruggiero [10] | 63 | 24 | 39 | 43–89 | 39 | 23 | 1 | P (34) | Multiple myeloma (29) | Sequestrectomy (45) |
| P; ZA (13) | Breast carcinoma (21) | Marginal mandibulectomy (4); +HBO (2) | ||||||||
| ZA (9) | Lung carcinoma (1) | Segmental mandibular resection (6) | ||||||||
| A (5) | Prostate carcinoma (3) | Partial maxillectomy (5) | ||||||||
| A; ZA (1) | Osteoporosis (7) | Complete maxillectomy (1) | ||||||||
| Risedronate (1) | Leiomyosarcoma (1) | |||||||||
| Leukemia (1) | ||||||||||
| Estilo [40] | 13 | 4 | 9 | 6 | 5 | 2 | Intravenous forms | Multiple myeloma (4) | ||
| Not specified | Breast carcinoma (9) | |||||||||
| Marx [8] | 36 | 29 | 5 | 2 | P (24) | Multiple myeloma (18) | ABs; rinses; minor debridement | |||
| P; ZA (6) | Breast carcinoma (17) | |||||||||
| ZA (6) | Osteoporosis (1) | |||||||||
Bisphosphonates—BPs; Antibiotics—ABs; HBO—hyperbaric oxygen therapy; Zoledronic acid—ZA; Pamidronate—P; Ibanronate—I; A—Alendronate