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Epidemiology and risk factors for osteonecrosis of the jaw in cancer patients

  1. Ana O. Hoff1,2,
  2. Bela Toth3,
  3. Mimi Hu4,
  4. Gabriel N. Hortobagyi5,
  5. Robert F. Gagel4

Article first published online: 28 SEP 2010

DOI: 10.1111/j.1749-6632.2010.05771.x

Issue

Annals of the New York Academy of Sciences

Annals of the New York Academy of Sciences

Additional Information

How to Cite

Hoff, A. O., Toth, B., Hu, M., Hortobagyi, G. N. and Gagel, R. F. (2011), Epidemiology and risk factors for osteonecrosis of the jaw in cancer patients. Annals of the New York Academy of Sciences, 1218: 47–54. doi: 10.1111/j.1749-6632.2010.05771.x

Author Information

  1. 1

    Department of Endocrinology, Fleury Group, Brazil.

  2. 2

    Department of Endocrinology, Instituto do Cancer Estado de São Paulo/Faculdade de Medicina da Universidade de São Paulo, Brazil.

  3. 3

    Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Texas.

  4. 4

    Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas M.D. Anderson Cancer Center, Texas.

  5. 5

    Department of Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Texas

*Address for correspondence: Ana O. Hoff, M.D., Av. Gen. Valdomiro de Lima, 508, 04344-903 São Paulo, SP, Brazil. ana.hoff@fleury.com.br

Publication History

  1. Issue published online: 3 FEB 2011
  2. Article first published online: 28 SEP 2010

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Keywords:

  • Paget's disease;
  • osteonecrosis of the jaw (ONJ);
  • cancer

Osteonecrosis of the jaw (ONJ), previously an entity associated with radiation therapy to the head and neck, has been observed in patients treated with bisphosphonates. Patients with metastatic breast cancer and myelomatous bone disease, commonly treated with high-potency nitrogen-containing bisphosphonates for a prolonged period of time, have the greatest risk of ONJ development. The reported frequency of ONJ ranges from 0.6% to 6.2% in breast cancer and from 1.7% to 15% in patients with multiple myeloma. Osteonecrosis of the jaw has also been observed in patients with other cancers such as prostate cancer and in benign bone disorders such as osteoporosis and Paget's disease in which the incidence is low. Risk factors associated with the development of ONJ include dental extractions, length of bisphosphonate treatment, and the type of bisphosphonate used. In this review, we summarize the reported incidence and risk factors associated with ONJ.

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