Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients

Abstract Medication-related osteonecrosis of the jaw is a rare but serious condition in which the jawbone fails to heal and becomes necrotic, typically after dental surgery in patients treated with bisphosphonates. However, clear evidence guiding how long bisphosphonate treatment should be paused be...

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Main Authors: Jung-Hyun Park, Sung Hye Kong, Jungsil Lee, Jongmin Oh, Jae-Ryun Lee, Hyo-Jung Lee, Jin-Woo Kim
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-59718-x
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author Jung-Hyun Park
Sung Hye Kong
Jungsil Lee
Jongmin Oh
Jae-Ryun Lee
Hyo-Jung Lee
Jin-Woo Kim
author_facet Jung-Hyun Park
Sung Hye Kong
Jungsil Lee
Jongmin Oh
Jae-Ryun Lee
Hyo-Jung Lee
Jin-Woo Kim
author_sort Jung-Hyun Park
collection DOAJ
description Abstract Medication-related osteonecrosis of the jaw is a rare but serious condition in which the jawbone fails to heal and becomes necrotic, typically after dental surgery in patients treated with bisphosphonates. However, clear evidence guiding how long bisphosphonate treatment should be paused before dental surgery remains limited. Here we show that a longer time since the last dose of intravenous bisphosphonate is associated with a reduced risk of jawbone necrosis. Using a nationwide retrospective cohort of 152,299 older adults diagnosed with osteoporosis, we analyze the relationship between the duration of bisphosphonate discontinuation prior to dental extraction and the occurrence of osteonecrosis of the jaw. We find that the risk is substantially lower when treatment is paused for more than 90 days, and lowest when the pause exceeds one year. The risk reduction appears more consistent with ibandronate, whereas with zoledronate, only pauses longer than one year show a meaningful association. These findings underscore the potential value of personalized prevention strategies based on bisphosphonate type.
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institution Kabale University
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publishDate 2025-05-01
publisher Nature Portfolio
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series Nature Communications
spelling doaj-art-65a7c85ab58e4364ab5dff35e5f25c192025-08-20T03:53:12ZengNature PortfolioNature Communications2041-17232025-05-0116111010.1038/s41467-025-59718-xTime since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patientsJung-Hyun Park0Sung Hye Kong1Jungsil Lee2Jongmin Oh3Jae-Ryun Lee4Hyo-Jung Lee5Jin-Woo Kim6Department of Oral and Maxillofacial Surgery, Ewha Womans University Mokdong HospitalDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Environmental Medicine, Ewha Womans University College of MedicineDepartment of Environmental Medicine, Ewha Womans University College of MedicineDepartment of Periodontology, Section of Dentistry, Seoul National University Bundang HospitalDepartment of Periodontology, Section of Dentistry, Seoul National University Bundang HospitalDepartment of Oral and Maxillofacial Surgery, Ewha Womans University Mokdong HospitalAbstract Medication-related osteonecrosis of the jaw is a rare but serious condition in which the jawbone fails to heal and becomes necrotic, typically after dental surgery in patients treated with bisphosphonates. However, clear evidence guiding how long bisphosphonate treatment should be paused before dental surgery remains limited. Here we show that a longer time since the last dose of intravenous bisphosphonate is associated with a reduced risk of jawbone necrosis. Using a nationwide retrospective cohort of 152,299 older adults diagnosed with osteoporosis, we analyze the relationship between the duration of bisphosphonate discontinuation prior to dental extraction and the occurrence of osteonecrosis of the jaw. We find that the risk is substantially lower when treatment is paused for more than 90 days, and lowest when the pause exceeds one year. The risk reduction appears more consistent with ibandronate, whereas with zoledronate, only pauses longer than one year show a meaningful association. These findings underscore the potential value of personalized prevention strategies based on bisphosphonate type.https://doi.org/10.1038/s41467-025-59718-x
spellingShingle Jung-Hyun Park
Sung Hye Kong
Jungsil Lee
Jongmin Oh
Jae-Ryun Lee
Hyo-Jung Lee
Jin-Woo Kim
Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
Nature Communications
title Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
title_full Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
title_fullStr Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
title_full_unstemmed Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
title_short Time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
title_sort time since last intravenous bisphosphonate and risk of osteonecrosis of the jaw in osteoporotic patients
url https://doi.org/10.1038/s41467-025-59718-x
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