INCIDENCE OF OSTEONECROSIS OF THE JAW NOT ASSOCIATED WITH ANTI-RESORPTIVE MEDICATIONS

• Author / Creator

  Singh,Vandana

• Objectives: Since 1993, there have been multiple case reports and small case series describing the apparently spontaneous occurrence of oral mucosal ulcers with a necrotic bone base, involving the posterior lingual mandible or exostoses, in patients not using anti-resorptive medications. Currently, this is referred to as oral ulceration with bone sequestration (OUBS). However, there have been no systematic studies and the incidence and significance of the condition is controversial. The aim of this study was to determine OUBS incidence and characteristic features in patients presenting in general dental practices.
  Methods: This was a clinical non-interventional cross sectional survey study involving the entire population of general dental practitioners (GDPs) in Alberta. A one-page survey was developed to determine characteristic features and incidence of OUBS as extrapolated from the number of patients in the care of respondents. The respondents were asked to provide an informed response after completing an educational exercise regarding the nature of the condition. To minimize notoriety bias, respondents were specifically requested to respond in the event they had never seen any OUBS cases. Further, respondents were asked to indicate only definitive cases in known patients not receiving anti-resorptive medications. There were at least two subsequent reminders published in the provincial newsletter.
  Results: 391 responses were accumulated representing about 20% of all active GDPs with a mean practice size of 1736 (SD=105). By extension, this represented the informed observations of about 685,000 (17% of the provincial population). Overall, 51 GDPs (13 %) had seen the OUBS condition at some point in their career. This number increased
  ii with years of practice experience reaching 22% of GDPs after 20-40 years. A total of 113 cases were described. There was a high predilection for lingual mandible (78%), including mandibular tori. Overall, 54% of cases involved the mandibular or palatal tori. 20 cases (18%) had been seen in the last 2 years, which represented a yearly incidence of 0.0015% or approximately 1 new OUBS case per year per 68 thousand patients not receiving anti- resorptive medications. This, in turn, corresponded to a 2.5% chance each year that a GDP serving this provincial population will see the condition. All cases resolved either spontaneously (77%) or following conservative management (23%). 68 % of cases persisted beyond 8 weeks before resolving.
  Conclusions: This data set represents the first systematic attempt to characterize OUBS presentation and assess incidence. OUBS is an unusual condition, occurring at an estimated 0.0015% yearly incidence in Alberta. This corresponds to about a 2.5% chance each year that a GDP will encounter the condition. Resolution occurred in all cases.

• Subjects / Keywords

  • Oral ulceration with bone sequestration

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R37P8TV8Z

• License

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