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Bisphosphonate-related osteonecrosis of the jaw is rare

A two-year national study based on patient case records has concluded that incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) can be considered as rare.

This study, a collaboration between the Faculty of General Dental Practice (UK) (FGDP [UK]) and the British Association of Oral and Maxillofacial Surgeons (BAOMS), was designed to capture all new referrals of patients with avascular necrosis of the jaw, including BRONJ, to oral and maxillofacial departments and dental hospitals in England, Wales, Scotland and Northern Ireland, from June 2009 to May 2011.

One of the two clinical leads for the study was Professor Simon Rogers for BAOMS, who commented: 'Although the data need to be interpreted with caution, the report would suggest that there are around 600 cases of BRONJ each year in the UK, and around 400 of these are related to oral bisphosphonates. Considering how commonly bisphosphonates are prescribed for conditions such as osteoporosis, these results should serve to reassure the public given the relative small number of cases of BRONJ each year. Further data and research is required.' The other clinical lead was Dr Nikolaus Palmer for the FGDP(UK), while other stakeholders included the British Society of Oral Medicine, the British Association of Oral Surgeons and the Faculty of Dental Surgery of the Royal College of Surgeons of England.

BRONJ can develop as an adverse effect of taking bisphosphonate medication, used for the management of osteoporosis and in the treatment of some cancers. Up until now there have been no published studies providing a reliable estimate of the incidence of avascular necrosis, specifically BRONJ, in the general population. This study aimed to give a better understanding of the incidence, case management and risk factors of BRONJ in relation to outcome for patient care management.

The full report can be viewed at www.fgdp.org.uk/research/facultystudiesprojects.ashx.

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Bisphosphonate-related osteonecrosis of the jaw is rare. Br Dent J 213, 594 (2012). https://doi.org/10.1038/sj.bdj.2012.1154

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