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"Expert Panel Recommendations for the Prevention, Diagnosis,
and Treatment of Osteonecrosis of the Jaws: June 2004"
http://www.ada.org/prof/resources/topics/topics_osteonecrosis_whitepaper.pdf
This pamphlet outlines the symptoms of ONJ and the different
procedures doctors may perform in order to make an accurate diagnosis.
The pamphlet also provides a list of factors that may increase
one’s risk of developing ONJ, as well as how to manage the
disease and treat patients with ONJ.
Http://www.fda.gov/medwatch/SAFETY/2004/safety04.htm#zometa
This website will direct you to the US Food and Drug Administration’s
Zometa Safety Alert, first posted on September 30, 2004.
http://www.fda.gov/medwatch/SAFETY/2004/ZometaHCP.pdf
This September 2004 letter was sent from Novartis to doctors,
making them aware of the changes they recently made to the Aredia
and Zometa US package inserts, now including a precautionary statement
regarding a possible risk of developing ONJ.
http://www.fda.gov/medwatch/SAFETY/2004/Zometa_PI.pdf
(In particular pages 9-11, 20)
In August 2004, Novartis revised the product information label
for Zometa, adding the risk of developing ONJ to their list of
precautions, as well as to their Post-Marketing Experience notes.
"Coping with Cancer: Dental Health and Osteonecrosis
of the Jaw"
http://www.us.novartisoncology.com/info/coping/dental_health.jsp
The Novartis Oncology website provides an overview of what a
person’s dental hygiene
routine should include if he or she has cancer. It also discusses
the risk of developing osteonecrosis of the jaw and the factors
that may increase the risk. Finally, it provides information regarding
diagnosis and treatment.
"Pamidronate (Aredia) and Zoledronate (Zometa) Induced
Avascular Necrosis of the Jaws: A Growing Epidemic
Robert E. Marx, Letter to the Editor, Journal of Oral Maxillofacial
Surgery. 61:1115-1118, 2003
Robert
E. Marx, Letter to the Editor.pdf
Dr. Marx’s letter describes his study of 36 ONJ cases. He
explains how he reached the conclusion that a connection exists
between ONJ and bisphosphonates. He describes common ONJ symptoms
and how bisphosphonates may affect the jawbone’s ability
to regrow. He concludes his letter by discussing methods of prevention
and possible treatments for ONJ.
"Bisphosphonates and Osteonecrosis of the jaw"
Patrick M Purcell and Ian W Boyd, Australian Health Review, eMJA
(Medical Journal of Australia)
https://www.mja.com.au/public/issues/182_08_180405/pur10144_fm.html
This article provides the clinical characteristics of 13 ONJ
patients, reported to the Adverse Drug Reactions Advisory Committee
(ADRAC). It provides the patients’ age and sex, which bisphosphonate(s)
they were treated with and why, how long they were receiving bisphosphonate
therapy before the onset of their ONJ, and their related symptoms.
ADA.org: A-Z Topics: Osteonecrosis of the Jaw
http://www.ada.org/prof/resources/topics/osteonecrosis.asp
This article provides information regarding dental management
for patients currently receiving intravenous bisphosphonate therapy.
It also includes a link to a document providing information on
obtaining informed consent regarding the risks associated with
long-term bisphosphonate use.
"Osteonecrosis of the Jaw"
http://courses.washington.edu/bonephys/opjawON.html
This article provides a simple overview of ONJ and includes a
detailed picture of exposed necrotic bone. It also includes simple
graphs displaying incidence of ONJ in cancer patients taking a
variety of bisphosphonates and a graph showing incidence of ONJ
after prolonged bisphosphonate use.
"Bisphosphonates May Put Patients At Risk For Deterioration
Of The Jaw, American Association of Endondontists"
Medical News Today, April 3, 2006
http://www.medicalnewstoday.com/medicalnews.php?newsid=40774
This article explains the American Association of Endodontists’
position statement regarding the recent findings regarding ONJ
and bisphosphonates. The AAE consider themselves at the forefront
of this emerging ONJ problem based on the fact that endodontists
are experts at finding the cause of oral and facial pain that
has been difficult to diagnose. The article explains the AAE’s
recommendations to those individuals currently taking bisphosphonates
and those individuals that think they may be experiencing ONJ
symptoms.
"Jaw Disease Found in Patients Using Cancer Drug"
Miguel Sanchez, Oral Cancer Foundation, March 6, 2006
http://www.oralcancerfoundation.org/news/story.asp?newsId=640
While this article discusses general information regarding ONJ
and the effects of prolonged bisphosphonate use, it also provides
an outline of the medical reasons why bisphosphonates, meant to
strengthen bones, can actually have an adverse affect on individuals’
jawbones.
Marx, Robert. Bisphosphonate-Induced Exposed Bone (Osteonecrosis/Osteopetrosis)
of the Jaws: Risk Factors, Recognition, Prevention and Treatment.
J Oral Maxillofac Surg 2005; 63 (11): 1567-75.
isphosphonate-Induced
Exposed Bone (Osteonecrosis/Osteopetrosis) of the Jaws
Dr. Marx presents a detailed article regarding his study of 119
ONJ patients, all who were treated with either oral or intravenous
bisphosphonates. He presents all of his findings, which demonstrate
that there exists a direct correlation between ONJ and the use
of bisphosphonates. The article includes Dr. Marx’s recommendations
for preventing and treating ONJ. The article contains many pictures
of exposed bone, tissue loss, drainage, x-rays of bone loss, and
pictures of infected, non-healing areas where extractions occurred.
"Jaw Ailment Shows Industry Moves Slowly on Drug Warnings"
Geeta Anana, The Wall Street Journal Online, Health, December
8, 2004.
http://online.wsj.com/public/resources/documents/SB110245057172293526.htm
Anana’s article describes Dr. Ruggiero’s research and
findings regarding his 90 bisphosphonate related ONJ cases. The
article also focuses on Novartis’ position on the link between
ONJ and Aredia and Zometa, as of December 2004. Anana describes
what steps the company has taken to issue warnings, how it plans
to continue investigating the problem, and what it plans to do
in the future.
"Drug Linked to Death of Jawbone"
Rita Rubin, USA TODAY, Health and Behavios, March 13, 2005
http://www.usatoday.com/news/health/2005-03-13-jawbone-deaths_x.htm
This article is a report on Dr. Salvatore Ruggiero’s findings
regarding the link between bisphosphonates and ONJ. The article
explains the effects that long-term use of bisphosphonates may
have on the body based on the fact that the drugs may remain in
bones for years after individuals stop taking them
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