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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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-05-01
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| 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. |
| format | Article |
| id | doaj-art-65a7c85ab58e4364ab5dff35e5f25c19 |
| institution | Kabale University |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| 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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