Incidence and risk factors of bisphosphonate-associated osteonecrosis of the jaws

Matthew R. Stumpe, Rakesh K. Chandra, Furhan Yunus, Sandeep Samant

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


Background. Intravenous bisphosphonate therapy has been used for treatment of benign and malignant bone diseases and has been linked to osteonecrosis of the jaws. Methods. Records of 638 patients treated with intravenous bisphosphonates were reviewed. Drug used, number of infusions, dosing interval, dosage, duration, and occasion of osteonecrosis, diagnosed by history and physical examination, were analyzed. Results. The overall incidence of osteonecrosis was 0.94% (6/638). No significant relationship was observed between the incidence of osteonecrosis and demographic parameters, primary tumor, cumulative drug dose, or dosing interval. However, patients who developed osteonecrosis had a significantly greater mean number of infusions (p = .016) and significantly greater mean hours of infusion time (p = .0036). Conclusions. The findings suggest positive correlation between the development of osteonecrosis and drug exposure as measured by number of infusions and total infusion hours. However, the relatively low incidence of osteonecrosis precluded definition of a direct dose-response relationship.

Original languageEnglish (US)
Pages (from-to)202-206
Number of pages5
JournalHead and Neck
Issue number2
StatePublished - Feb 2009


  • Bisphosphonate
  • Incidence
  • Mandible
  • Maxilla
  • Osteonecrosis

ASJC Scopus subject areas

  • Otorhinolaryngology


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