Session: SAT 248-267-Osteoporosis II
Poster Board SAT-266
This study was conducted in the State of Victoria, Australia: 4212 patients aged over 50 years seen by a dental specialist (oral and maxillofacial surgeon or special needs dentist) during a 6 month period in 2006 were compared with age- and gender-matched controls also matched for referral source (4 controls/case). History of cancer or local radiotherapy was an exclusion. Of the 40 DDH cases confirmed by a blinded adjudication panel, 21 had a record of bisphosphonate use (20 alendronate users, 1 risedronate user, no intravenous bisphosphonate recipients). All bisphosphonate -associated cases also met the definition of ONJ (> 8 weeks without healing). Having a medical condition not directly related to bisphosphonate use (e.g., cardiovascular, respiratory or renal disease) was a weak independent predictor of DDH (OR 2.3, 95% CI 1.0 to 5.2, P = 0.04). Smoking and low socioeconomic status also were risk factors for DDH. 39 of 40 DDH cases had a recorded dental procedure (e.g., dental extraction, implant, implant failure) as a possible precipitant. The estimated prevalence of DDH in patients aged > 50 years, taking a bisphosphonate and attending a dental specialist was 3.5 % (slightly under 1 in 30). This case-control study provides unique new information supporting a clinically-relevant association between oral bisphosphonate therapy and delayed dental healing/jaw osteonecrosis in patients with non-cancer-related bone disease. Importantly, a dental procedure was identified as a precipitant of DDH in almost all cases. More research is needed to define the incidence and to further characterise risk factors for DDH and ONJ in this large segment of the population.
Disclosure: JDW: Consultant, Amgen, Principal Investigator, Eli Lilly & Company, Principal Investigator, Eli Lilly & Company, Consultant, Merck & Co., Principal Investigator, Merck & Co., Consultant, Novartis Pharmaceuticals, Principal Investigator, Novartis Pharmaceuticals, Consultant, Sanofi, Principal Investigator, Sanofi, Consultant, Servier, Principal Investigator, Servier, Speaker, Eli Lilly & Company, Speaker, Novartis Pharmaceuticals, Speaker, Servier. Nothing to Disclose: CB, JC, MM, LC, GH, GB
*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm
See more of: Abstracts - Orals, Featured Poster Presentations, and Posters