Table 1: Main characteristics of the included studies.

Reference Study Population Follow-Up Intervention Results Quality Of Evidence (Sign)

Bagan [7]

Objectives: Describe clinical characteristics and the evolution of a series of patients who develop ONJ after treatment for osteoporosis (OP) with denosumab (Dmab) Search period: not specified

N: 10 patients

Mean age: 73.7 ± 11.6 years

Sex: 100% women

Exclusion criteria were treatment with other medications or chemotherapy for associated cancers

Intervention: Treatment with Dmab (60 mg)/6 months Follow-up period:not specified

-The average number of doses of denosumab was 3.4 ± 2.2.

9 patients (90%) had also been treated before with oral BPs, for an average of 44.7 ± 25.11 months ( 4 with ibandronate, 3 with risedronate and 3 with alendronate. -In 7 (70%), the ONJ was located in the jaw.

- The most common local risk factor found was tooth extraction (six cases, 60%); Only one case associated with dental implant was found. Three cases (30%) had an intraoral and necrotic fistula and in 9 cases (90%) bone exposure was observed.

- Bone sclerosis was present in all cases. No sequestration was found in any case, osteolysis was present in six (60%) cases.

- Stage 1 of ONJ was the most common, occurring in eight (80%) cases, and in all cases except one, conservative treatment was used with the healing of the lesions


Oliveira [6]

Design: Systematic review of cases and series of cases Objectives: Review the literature of clinical cases that develop ONM after treatment with Dmab Search period: January 2010 to May 2015

N:17 patients 8 OP (mean age: ≥ 60 (58-78a). 100% women. 9 Cancer. To be included, the articles had to be a case or a series of clinical cases in patients ≥ 18 years of who used Dmab for the treatment of osteoporosis including patients with Cancer and who had received some therapy for ONJ.

Treatment with Dmab (60 mg)/6 months

-Of the 17 cases detected only 8 were in patients with osteoporosis and osteopenia.

-The majority of cases of ONJ occurred in the posterior mandibular area and only one of them in the posterior maxillary area.

-The associated systemic factors were:

-Previous appointment with BPs (in 6 of 8 cases).

-Dental extractions (4 of the 8 cases).