Details

Autor(en) / Beteiligte

• Schwaneck, E. C.
• Streit, A.
• Krone, M.
• Hartmann, S.
• Müller-Richter, U.
• Kübler, A. C.
• Gadeholt, O.
• Schmalzing, M.
• Tony, H.-P.
• Brands, R. C.

Titel

Osteoporosis therapy in patients with inflammatory rheumatic diseases and osteonecrosis of the jaw

Ist Teil von

• Zeitschrift für Rheumatologie, 2020-03, Vol.79 (2), p.203-209

Ort / Verlag

Heidelberg: Springer Medizin

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Background and objectives The aim of the present study was to assess the prevalence of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients suffering from inflammatory rheumatic diseases, as well as to assess the prevalence of relevant dental, behavioral, and medical risk factors for MRONJ. Materials and methods A total of 198 patients with inflammatory rheumatic diseases and osteoporosis therapy were recruited from a tertiary rheumatological/immunological referral center between June 2015 and September 2016. They were assessed using a structured interview. A maxillofacial surgeon later examined patients complaining of possible symptoms of osteonecrosis. In cases of osteonecrosis, dental records were obtained and evaluated. Preventive measures taken and dental as well as other clinical risk factors were evaluated. Results Of the 198 patients, three suffered from osteonecrosis of the jaw, none of whom had any history of malignant disease or radiation therapy, resulting in a prevalence of 1.5%. Of these three patients, only one was given bisphosphonates intravenously (i.v.), whereas all three had been treated orally. All three diagnoses of MRONJ had been previously known to the patients and their maxillofacial surgeons. Two of the patients had rheumatoid arthritis, and one patient suffered from large vessel vasculitis. Long anti-osteoporotic treatment duration, low functional status, and low bone density of the femur were significantly associated with MRONJ development. Conclusion Inflammatory rheumatic diseases constitute a risk factor for MRONJ in patients treated with bisphosphonates for osteoporosis. Patients should be counseled accordingly and should be offered dental screening and regular dental check-ups.