Summary of: a study of 225 patients on bisphosphonates presenting to the bisphosphonate clinic at King's College Hospital.

Aim: The aim of this retrospective study was to examine the outcome of patients referred to a dedicated clinic for dental extractions while they were prescribed either oral or intra-venous (IV) bisphosphonates (BPs). The following parameters were assessed: mode of BP administration, indication for BP prescription, incidence of BRONJ, concomitant risk factors for development of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and demographic details.

Material And Methods: The clinical records of 225 patients who underwent dental extraction while receiving oral or intravenous bisphosphonates were reviewed. Their clinical outcome, specifically the development of BRONJ was determined.

Results: Of the 225 patients, 202 were prescribed oral and 23 IV BPs. 34.8% (8/23) of patients prescribed IV BPs developed BRONJ following dental extraction, which was a significantly (p <0.001) higher proportion than that of the oral BP group, which was 2.5% (5/202 patients). 12.3% (8/65) patients taking BPs with steroids were at a significantly increased risk of a BRONJ (p <0.003). 12.3% (7/57) males developed a BRONJ compared with 3.6% (6/168) females where p = 0.015. All of the patients who developed a BRONJ as a result of oral BP prescription had been taking this medication for three years or more.

Conclusion: In our patient cohort the risk of developing a BRONJ following dental extractions was greatest in those patients receiving IV BPs and those on oral BPs with concomitant steroid medication.