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

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(s): To assess our cohort of paediatric patients treated with intravenous bisphosphonate for occurrence of ONJ. Design(s): Observational study at a tertiary children's hospital. Patient(s): 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. Result(s): In all patients assessed, including 11 who had invasive dental treatment, there were no cases of osteonecrosis. Conclusion(s): ONJ has so far not been demonstrated in this patient group. © 2008 The Authors.