Eur Urol. 2008;54:1066-1072

Bisphosphonate-associated osteonecrosis of the jaw (BP-ONJ) may be an underestimated problem in prostate cancer patients treated with zoledronate, German investigators suggest.

In a study of 43 patients with advanced prostate cancer and osseous metastasis receiving bisphosphonate therapy, BP-ONJ developed in eight patients (18.6%). Previous studies of prostate cancer patients taking bisphosphonates have found incidences of 2.9% to 6.5%. All eight patients in the German study had received zoledronate at least 14 times and all had had a previous tooth extraction or a denture pressure sore.

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The higher incidence of BP-ONJ found in the new study might be related to the study’s prospective design, the authors noted. In addition, unlike most other studies, all subjects had a dental examination.