November 07, 2013
1 min read

Diabetes microvascular disease may lead to bisphosphonate-related osteonecrosis of the jaw

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The development of bisphosphonate-related osteonecrosis of the jaw could be associated with diabetes through microvascular complications. In particular, the presence of diabetic nephropathy increased this association 3.9-fold, according to data.

Previous studies have demonstrated a higher rate of diabetes or impaired fasting glucose among patients treated with bisphosphonates and diagnosed with bisphosphonate-related osteonecrosis of the jaw, according to researchers. In this cross-sectional retrospective study, researchers at Rambam Medical Center in Technion, Haifa, Israel, sought to re-examine this cohort.

They included patients (n=46; 22 men, 24 women) treated with bisphosphonates who also were diagnosed with bisphosphonate-related osteonecrosis of the jaw between 2009 and 2012. They were compared with controls without the disease (n=38; 18 men, 20 women), according to data.

Of 46 patients with the disease, 31 (67.4%) also had diabetes or IFG; the amount of patients with diabetes (37%) in this group was greater compared with controls (26.3%; P=.009), according to data.

There was a significant association between diabetes or IFG and bisphosphonate-related osteonecrosis of the jaw (2.78; 95% CI, 1.27-6.07); microvascular disease (ie, neuropathy, retinopathy, nephropathy) was significantly more common among patients with the disease compared with controls (P=.01). Specifically, those with nephropathy displayed a 3.9-fold association with the disease (95% CI, 1.12-13.52), according to researchers.

“The likelihood of a concomitant diagnosis of [bisphosphonate-related osteonecrosis of the jaw] with [diabetes] is supported by the immunosuppression and delayed wound healing that is known to occur in patients with poorly controlled [diabetes] after dental surgery or trauma,” the researchers wrote.

Limitations include the incomplete data of the study. However, researchers wrote that appropriate dental hygiene is necessary to prevent oral surgical interventions until new strategies based on evidence-based clinical studies are developed.

Disclosure: The researchers report no relevant financial disclosures.