Bisphosphonate-associated osteonecrosis of the jaw: does it occur in children?

Clin Endocrinol (Oxf). 2008 Jun;68(6):863-7. doi: 10.1111/j.1365-2265.2008.03189.x. Epub 2008 Jan 21.

Abstract

Background: Bisphosphonate use in adult patients has been linked to osteonecrosis of the jaw (ONJ). This complication has not been systematically assessed in a paediatric population receiving bisphosphonates.

Objective: To assess our cohort of paediatric patients treated with intravenous bisphosphonate for occurrence of ONJ.

Design: Observational study at a tertiary children's hospital.

Patients: A total of 42 paediatric patients with osteoporosis who received bisphosphonate infusions for a mean of 6.5 years (SD 2.7 years) were assessed clinically and radiographically for possible ONJ. Among 42, 37 patients had received disodium pamidronate 1 mg/kg/dose at a mean cumulative dose of 19.8 mg/kg and zoledronic acid (ZA) 0.05 mg/kg/dose at a mean cumulative dose of 0.49 mg/kg; four had received ZA and one received pamidronate alone. Invasive dental treatment during bisphosphonate treatment, a known risk factor for osteonecrosis, was specifically assessed.

Results: In all patients assessed, including 11 who had invasive dental treatment, there were no cases of osteonecrosis.

Conclusion: ONJ has so far not been demonstrated in this patient group.

MeSH terms

  • Adolescent
  • Bone Density Conservation Agents / adverse effects*
  • Child
  • Cohort Studies
  • Diphosphonates / adverse effects*
  • Humans
  • Imidazoles / adverse effects*
  • Jaw Diseases / chemically induced*
  • Oral Surgical Procedures / adverse effects
  • Osteonecrosis / chemically induced*
  • Pamidronate
  • Zoledronic Acid

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Zoledronic Acid
  • Pamidronate