Osteonecrosis of the jaw (ONJ) is a debilitating bone condition that affects the jaws and occurs as a result of reduced local blood supply to the bone. The literature in this area has been severely limited since most investigations cannot evaluate sufficient numbers of afflicted individuals to accurately determine the incidence of the disease and associated risk factors. Today, the International and American Associations for Dental Research's Journal of Dental Research (JDR) released a research report that estimates the prevalence of the disease, and a case-control study on bisphosphonate use and other risk factors. These investigations published in the JDR represent some of the largest published studies to date on ONJ patients, and the researchers involved utilized the National Institute of Dental and Craniofacial Research-supported Practice-based Research Networks (PBRNs).
In a JDR article titled "Risk Factors for Osteonecrosis of the Jaws: a Case-control Study," authors A. Barasch, J. Cunha-Cruz, F.A. Curro, P. Hujoel, A.H. Sung, D. Vena and A.E. Voinea-Griffin conducted a case-control study with three DPBRNs to determine the risk associated with bisphosphonates and identify other risk factors for ONJ, including dental diseases and procedures. Researchers enrolled 191 ONJ cases and 573 controls from 119 dental practices. Bisphosphonate use was strongly associated with ONJ with an odds ratio of 299.5 for intravenous use and 12.2 for oral use.
In a second JDR article titled "ONJ in Two Dental Practice-Based Research Network Regions," authors J.L. Fellows, D.B. Rindal, A. Barasch, C.M. Gullion, W. Rush, D.J. Pihlstrom and J. Richman conducted a Dental Practice-based Research Network (DPBRN) study that estimated ONJ incidence and odds ratios from bisphosphonate exposure and other risk factors using patients' electronic records. The researchers identified 572,606 health plan members and of those patients, approximately 25,000 had a diagnosis or procedure code that suggested a necrotic bone lesion, including inflammatory jaw condition, cyst of bone, aseptic necrosis of the bone and open wound of the jaw. Of those members' electronic medical records, 73 suspected ONJ cases were identified, of which 16 were later confirmed by manual chart review. An additional seven cases were unidentified through oral surgeons or the Peer Review Committee for a total of 23 confirmed ONJ cases. Patients with oral bisphosphonates were 15.5 times more likely to have ONJ than non-exposed patients. However, the number of ONJ cases limits firm conclusions and suggests absolute risks for ONJ from oral bisphosphonates is low.
"ONJ represents a challenging clinical dilemma affecting dental and cancer patients, and communities at many levels of dentistry, notably oral/maxillofacial surgery and oral oncology are called upon to manage these cases," stated JDR Editor-in-Chief William Giannobile. "The work underscores important clinical implications that will be of value to not only the IADR and AADR communities, but especially practicing clinicians.
A perspective article titled "Making a Case for Defining Osteonecrosis of the Jaw" was written by C. Van Posznak, breast cancer oncologist expert on the topic. In it, she summarizes the key implications of ONJ and the relevance in the field of the two JDR research reports. The research that was conducted may have an important impact to the developing of better definitions for ONJ.
All three of these articles are published in the Journal of Dental Research. Visit jdr.sagepub.com/content/early/recent for links to the complete articles or contact Ingrid L. Thomas at firstname.lastname@example.org to request the PDFs.
About the Journal of Dental Research -The IADR/AADR Journal of Dental Research is a multidisciplinary journal dedicated to the dissemination of new knowledge in all sciences relevant to dentistry and the oral cavity and associated structures in health and disease. At 4.195, the JDR holds the highest Five-Year Impact Factor of all dental journals publishing original research, with a cited half-life >10 years, reflecting the influential nature of the Journal's content. It also has the highest Eigenfactor Score in the field.
About the International Association for Dental Research -The International Association for Dental Research (IADR) is a nonprofit organization with nearly 12,500 individual members worldwide, dedicated to: (1) advancing research and increasing knowledge to improve oral health, (2) supporting the oral health research community, and (3) facilitating the communication and application of research findings for the improvement of oral health worldwide. To learn more, visit www.iadr.org. The American Association for Dental Research (AADR) is the largest Division of IADR, with nearly 4,000 members in the United States. To learn more, visit www.aadronline.org