What Researchers Did
Researchers reviewed historical and current cases of bisphosphonate osteochemonecrosis, also called "bis-phossy jaw," comparing it to 19th-century "phossy jaw" and osteoradionecrosis.
What They Found
The descriptions of phossy jaw and current bis-phossy jaw cases were remarkably similar, with bisphosphonates appearing to be a necessary factor in bis-phossy jaw. Histopathologic features of bis-phossy jaw included intact vascular channels even with inflammation, and non-vital bone fragments showing reduced osteoclastic activity. The study suggests bis-phossy jaw may involve a bacterial cofactor more than osteoradionecrosis, and avascularity does not seem to be a major factor.
What This Means for Canadian Patients
This review highlights the importance of understanding bisphosphonate-related jaw complications for Canadian patients undergoing treatment with these drugs. Recognizing the similarities to historical conditions and the potential role of bacterial factors can guide prevention and early identification strategies. Patients taking bisphosphonates should be aware of potential jaw issues and discuss any concerns with their healthcare providers.
Canadian Relevance
This study was not conducted by Canadian authors or in Canada. While primarily focused on bisphosphonate osteochemonecrosis, this review article discusses osteoradionecrosis, which is a Health Canada-recognized indication for hyperbaric oxygen therapy.
Study Limitations
This was primarily a review article, and the laboratory's own observations were limited to 20 suspected cases, which may not represent all presentations of the condition.