Comorbid conditions are a risk for osteonecrosis of the jaw unrelated to antiresorptive therapy

Abstract

Objective: Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJ_uat), confounding risk assessment. This study aimed to determine if ONJ_uat is associated with one or more particular comorbidities.

Study design: This was a retrospective case-control study of patients with ONJ_uat and delayed healing (DH). Each case was matched for patient age and gender, as well as location of ONJ_uat or DH lesion to a control patient who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking.

Results: Of the 92 patients identified, 67 (73%) met the criteria for ONJ_uat and 25 (27%) for DH. The most common trigger for ONJ and DH was extraction (50%). The presence of any comorbidity (i.e., at least 1) was more prevalent in ONJ_uat than among controls (P = .04), and there were more comorbidities in patients with ONJ_uat and DH than in controls [M(SD) = 1.94 (1.2) and 2.0 (1.3) vs 1.26 (0.89); both P < .001].

Conclusions: ONJ and DH are not limited to patients with a history of antiresorptive therapy. More comorbidities may signal increased risk for ONJ_uat and DH.