Prevalence of bisphosphonate associated osteonecrosis of the jaws in multiple myeloma patients 英文参考文献.docVIP
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Prevalence of bisphosphonate associated osteonecrosis of the jaws in multiple myeloma patients 英文参考文献
Walter et al. Head Face Medicine 2010, 6:11
/content/6/1/11
HEAD FACE MEDICINE
RESEARCH
Open Access
Prevalence of bisphosphonate associated Research
osteonecrosis of the jaws in multiple myeloma
patients
Christian Walter*1, Bilal Al-Nawas1, Norbert Frickhofen2, Heinold Gamm3, Joachim Beck3, Laura Reinsch1,
Christina Blum1, Knut A Gr?tz1,4 and Wilfried Wagner1
Abstract
Background: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is an adverse effect of bisphosphonate
treatment with varying reported incidence rates.
Methods: In two neighboring German cities, prevalence and additional factors of the development of BP-ONJ in
multiple myeloma patients with bisphosphonates therapy were recorded using a retrospective (RS) and cross-sectional
study (CSS) design. For the RS, all patients treated from Jan. 2000 - Feb. 2006 were contacted by letter. In the CSS, all
patients treated from Oct. 2006 - Mar. 2008 had a physical and dental examination. Additionally, a literature review was
conducted to evaluate all articles reporting on BP-ONJ prevalence. PubMed search terms were: bisphosphonat,
diphosphonate, osteonecrosis, prevalence and incidence.
Results: In the RS, data from 81 of 161 patients could be obtained; four patients (4.9%) developed BP-ONJ. In the CSS,
16 of 78 patients (20.5%) developed BP-ONJ. All patients with BP-ONJ had received zoledronate; 12 of these had had
additional bisphosphonates. All except one had an additional trigger factor (tooth extraction [n = 14], dental surgical
procedure [n = 2], sharp mylohyoid ridge [n = 3]).
Conclusion: The prevalence of BP-ONJ may have been underestimated to date. The oral examination of all patients in
this CSS might explain the higher prevalence, since even early asymptomatic stages of BP-ONJ and previously
unnoticed symptomatic BP-ONJ were recorded. Since nearly all patients with BP-ONJ had an additional trigger factor,
oral hygiene and dental care might help to reduce BP-ONJ incidence.
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