Osteomylelitis and necrosis of the jaw in patients treated with bisphosphonates: a comparative study focused on multiple myeloma

Clin Lab Haematol. 2006 Dec;28(6):393-8. doi: 10.1111/j.1365-2257.2006.00841.x.

Abstract

It was reported that multiple myeloma (MM)-patients suffer from a higher incidence of osteomyelitis and necrosis of the jaws than patients treated with bisphosphonates for other reasons. The aim of this study is to report about 57 cases of bisphosphonate-related osteomyelitis and necrosis of the jaws (BON) and to investigate the differences between BON in MM and non-MM patients. Clinical and laboratory data of 57 cases were assessed. The features of BON and clinical-outcome were compared between the two groups. Treatment approach was assessed as a contributing-factor to treatment-outcome. Clinical presentation included exposed bone, pain, swelling and suppuration with little variation between the two groups. Past dento-alveolar surgery was common in both study-groups. Treatment outcome was poor (33% and 25% responded to treatment in MM group and non-MM group, respectively). Treatment modality did not affect the treatment outcome. The clinical presentation described in this case series should alert the physician to the possibility of BON. Although the literature shows a higher incidence of BON in MM patients compared to non-MM patients, our study suggests that the severity of the clinical presentation and the response to treatment are not worse in MM patients compared with non-MM patients. The predisposition of MM patients to BON should be further investigated.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Cohort Studies
  • Diphosphonates / adverse effects*
  • Diphosphonates / therapeutic use
  • Female
  • Humans
  • Jaw / pathology*
  • Jaw Diseases / etiology*
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Necrosis / chemically induced
  • Necrosis / drug therapy
  • Necrosis / surgery
  • Osteomyelitis / chemically induced*
  • Osteomyelitis / drug therapy
  • Osteomyelitis / surgery
  • Risk Factors

Substances

  • Diphosphonates