[Oradlist] mail survey

[alexandre khairallah]

Dear All

  

I'm following with much of interest all the debate about the BONJ that is carried out between the ORAD list members since I was confronted with a few cases of BONJ in my radiological practice. 
To understand the procedure of BIONJ I read an article on the journal of clinical oncology that I advise you to read
 
http://meeting.ascopubs.org/cgi/content/abstract/24/18_suppl/18621  
 
Best regards
 
Alexandre Khairallah
DCD Oral Radiologist 
Lebanese University 
Dental School
 


Date: Mon, 4 May 2009 15:43:18 -0400
From: lurie at nso.uchc.edu
To: oradlist at lists.ucla.edu
Subject: Re: [Oradlist] mail survey

Dear ORAD Listers,

I have never, in my aging memory, sent a hostile email to the list.  However, yet again we have a case of ONJ being subtly mis-represented.  Following is the concluding paragraph from the report:


“Chronic refractory osteomyelitis of the jaws (CROJ) is a potential side effect of bisphosphonates, in particular with zoledronic acid. Both mandible and maxilla can be affected. The treatment of CROJ should be, if possible, discontinuation of the zoledronic acid therapy, in combination with a surgical debridement of the osteonecrotic lesion, a strict antibiotic protocol and a meticulous oral hygiene by the patient.”

This patient had intravenous bisphosphonate therapy as part of treatment for breast cancer.  The vast majority of ONJ which is related to bisphosphonate therapy is thus.  The cases of ONJ which are related to oral bisphosphonate therapy for osteopenia and osteoporosis is miniscule compared to the millions and millions – perhaps tens of millions – of patient receiving such therapy.  Physicians, dentists and patients are being excessively, and in my opinion unnecessarily, sent into a quasi-panic mode by such representations.  Review of the literature concerning ONJ from oral bisphosphonate therapy is thin at best.  We need controlled, prospective studies before potentially condemming a superb treatment of bone demineralizing diseases which cause such tremendous morbidity and mortality worldwide. 

We should all be exceptionally clear when we report any ONJ cases such as this that we clearly state, throughout the report, that the patient received intravenous bisphosphonate treatment. 


On 5/4/09 3:25 PM, "Johan Aps" <johan.aps at ugent.be> wrote:

> Dear OradFriends,
> 
> I hereby repost my mail of 8 April 09 again with the PDF file on  
> bisphosphonates.
> I hope this may be of any help to anyone who is keen on this  
> interesting issue.
> 
> Kind regards from Belgium (it is 9.25 PM now)
> 
> Johan

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