Potential significance of antiestrogen therapy in the development of bisphosphonate related osteonecrosis of the jaw

J Craniomaxillofac Surg. 2014 Dec;42(8):1932-6. doi: 10.1016/j.jcms.2014.08.002. Epub 2014 Aug 20.

Abstract

Objectives: There are known risk factors and established treatment protocols for bisphosphonate-related osteonecrosis of the jaw (BRONJ), but it remains a difficult disease to treat, with the risk of relapses. This study investigates whether or not there is a relationship between antiestrogen therapy and BRONJ.

Patients and methods: In our prospective study, we followed up 93 patients with BRONJ who were seen at our clinic between 2006 and 2011.

Results: We found that breast cancer patients had a significantly worse prognosis than patients with other underlying illnesses (p < 0.01), which might indicate the role of antiestrogen therapy (p < 0.001) as a causative factor.

Conclusion: The dominance of the female gender among BRONJ patients as well as our new findings related to antiestrogen therapy of breast cancer raise the possibility that estrogen deficiency might be a newly discovered risk factor for BRONJ.

Keywords: Antiestrogen therapy; Bisphosphonate; Breast cancer; Estrogen deficiency; Jaw; Osteonecrosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / etiology*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery
  • Bone Density Conservation Agents / adverse effects
  • Breast Neoplasms / drug therapy
  • Estrogen Receptor Modulators / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Neoplasm Recurrence, Local / pathology
  • Osteoporosis / drug therapy
  • Prognosis
  • Prospective Studies
  • Prostatic Neoplasms / drug therapy
  • Risk Factors

Substances

  • Antineoplastic Agents, Hormonal
  • Bone Density Conservation Agents
  • Estrogen Receptor Modulators