Is bisphosphonate therapy for benign bone disease associated with impaired dental healing? A case-controlled study

BMC Musculoskeletal Disorders

Study Protocol

Elly Flitzanis¹  Gelsomina L Borromeo¹  Michael McCullough¹  John G Clement¹  Wendy Thomson¹  John D Wark²  Caroline Brand³ 

[1] Melbourne Dental School, The University of Melbourne, 720 Swanston Street Victoria, 3010, Australia;University of Melbourne, Department of Medicine, and Bone and Mineral Service Royal Melbourne Hospital, 3050, Parkville, Australia;University of Melbourne, Department of Medicine, and Bone and Mineral Service Royal Melbourne Hospital, 3050, Parkville, Australia;Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, 3050, Parkville, Australia;

关键词: Bisphosphonate;    Zoledronate;    Osteonecrosis;    Postmenopausal Osteoporosis;    Pamidronate;   

DOI  :  10.1186/1471-2474-12-71

 received in 2011-03-13, accepted in 2011-04-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundBisphosphonates are common first line medications used for the management of benign bone disease. One of the most devastating complications associated with bisphosphonate use is osteonecrosis of the jaws which may be related to duration of exposure and hence cumulative dose, dental interventions, medical co-morbidities or in some circumstances with no identifiable aggravating factor. While jaw osteonecrosis is a devastating outcome which is currently difficult to manage, various forms of delayed dental healing may be a less dramatic and, therefore, poorly-recognised complications of bisphosphonate use for the treatment of osteoporosis. It is hypothesised that long-term (more than 1 year's duration) bisphosphonate use for the treatment of post-menopausal osteoporosis or other benign bone disease is associated with impaired dental healing.Methods/DesignA case-control study has been chosen to test the hypothesis as the outcome event rate is likely to be very low. A total of 54 cases will be recruited into the study following review of all dental files from oral and maxillofacial surgeons and special needs dentists in Victoria where potential cases of delayed dental healing will be identified. Potential cases will be presented to an independent case adjudication panel to determine if they are definitive delayed dental healing cases. Two hundred and fifteen controls (1:4 cases:controls), matched for age and visit window period, will be selected from those who have attended local community based referring dental practices. The primary outcome will be the incidence of delayed dental healing that occurs either spontaneously or following dental treatment such as extractions, implant placement, or denture use.DiscussionThis study is the largest case-controlled study assessing the link between bisphosphonate use and delayed dental healing in Australia. It will provide invaluable data on the potential link between bisphosphonate use and osteonecrosis of the jaws.

【 授权许可】

CC BY   
© Borromeo et al; licensee BioMed Central Ltd. 2011