Potential significance of antiestrogen therapy in the development of bisphosphonate related osteonecrosis of the jaw

ObjectivesThere are known risk factors and established treatment protocols for bisphosphonate-related osteonecrosis of the jaw (BRONJ), but it remains a difficult disease to treat, with the risk of relapses. This study investigates whether or not there is a relationship between antiestrogen therapy and BRONJ.Patients and methodsIn our prospective study, we followed up 93 patients with BRONJ who were seen at our clinic between 2006 and 2011.ResultsWe found that breast cancer patients had a significantly worse prognosis than patients with other underlying illnesses (p < 0.01), which might indicate the role of antiestrogen therapy (p < 0.001) as a causative factor.ConclusionThe dominance of the female gender among BRONJ patients as well as our new findings related to antiestrogen therapy of breast cancer raise the possibility that estrogen deficiency might be a newly discovered risk factor for BRONJ.