TITLE:
Prevalence of Osteonecrosis of the Jaw (ONJ) in Patients Exposed to Bisphosphonates at a University Hospital in Marrakech
AUTHORS:
Aicha Oubbaih, Mouad Mouhtaram, Youness Moutaabid, Bouchra Badre, Samira Bellemkhannate, Nadia Zaim
KEYWORDS:
Bisphosphonate-Related Osteonecrosis of the Jaw, Bisphosphonates, Osteonecrosis of the Jaw, Prevalence
JOURNAL NAME:
Open Journal of Epidemiology,
Vol.15 No.1,
February
8,
2025
ABSTRACT: Background: Bisphosphonates are compounds similar to inorganic pyrophosphates, with anti-angiogenic, anti-inflammatory, anti-bone resorption, and antitumor effects. They are used to prevent bone metastases in cancer and treat osteoporosis. However, a major side effect is osteonecrosis of the jaw (ONJ), first reported in 2003, which is the exposure of necrotic bone in the mouth, often accompanied by infection. Prevention and treatment of ONJ remain challenging due to a lack of reliable epidemiological data on its incidence and risk factors. The aim of our work is to estimate the prevalence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and to analyze its correlations with different risk factors reported in the literature. Methods: A retrospective observational study was conducted in the Oncology, Rheumatology and Maxillofacial Surgery Department of the Mohamed VI University Hospital; Marrakech, based on complete medical records during the period 2017 to 2022, as well as consultations of patients under bisphosphonates in these departments during July and August 2022. Statistical analysis was performed using IBM SPSS version 16.0. Results: Of the 107 patients included in this study, 60.7% were women, and 56.1% were between 40 and 65 years old. 100% of the patients suffered from a general pathology. Regarding treatment with BP, 103 patients were treated with Zoledronate, 4 with Risedronate, and 5 with Ibandronate. 103 patients received this treatment intravenously, while 4 patients received it orally. Regarding Oral health, only 12.1% of patients reported a poor oral health. 99.1% of patients were informed of the need for oral preparation prior to BP treatment, but only 71.02% received dental treatment, mainly tooth extraction. None of the patients were diagnosed with BRONJ. Conclusions: While the global incidence of ONJ ranges from 0.8% to 12%, our finding is zero. Most previous studies are retrospective with limited patient numbers like our study. To accurately assess the prevalence of ONJ, further prospective epidemiological studies with standardized protocols and thorough follow-up over several years are essential.