Osteonecrosis of the jaw in patients transitioning from bisphosphonates to denosumab treatment for osteoporosis

摘要: Antiresorptive-related osteonecrosis of the jaw (ARONJ) is a rare but severe side effect antiresorptive treatment with bisphosphonates or RANKL-antibody denosumab in patients malignant diseases osteoporosis. Whilst (ONJ) related to administration (BPs) has been investigated for more than 1 decade now, only few data are available on denosumab-related ONJ, especially From 2008 2016, 52 osteoporosis were treated ARONJ Department Oral and Maxillofacial Surgery, University Medical Center Freiburg, Germany. In all patients, surgical regimen consisting complete removal necrotic bone, primary wound closure perioperative i.v. antibiotic therapy was applied. Of 38 developed after BP monotherapy; 11 had transitioned from BPs 3 received monotherapy. July 2013, when first patient ONJ transitioning presented our department, October we found recurrences 17.6% monotherapy 45.5% denosumab. Transitioning may be an additional risk factor developing ARONJ. these ARONJ-lesions seems provoke complications. An dental screening before should initiated. Further studies needed evaluate if first-line decreases incidence simplifies its treatment.