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Although the risk of <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content> increases with increasing duration of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> treatment, there are currently no reliable estimates of the <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content> time to onset (<jats:styled-content style=\"fixed-case\">TTO<\/jats:styled-content>). The objective of this study was to estimate the <jats:styled-content style=\"fixed-case\">TTO<\/jats:styled-content> and associated risk factors in <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Retrospective analysis of data from 22 secondary care centres in seven countries relevant to 349 patients who developed <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content> between 2004 and 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">TTO<\/jats:styled-content> was 6.0 years in patients treated with alendronate (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>88) and 2.2\u00a0years in those treated with zoledronate (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>218). Multivariable Cox regression showed that dentoalveolar surgery was inversely associated, and the use of antiangiogenics directly associated, with the <jats:styled-content style=\"fixed-case\">TTO<\/jats:styled-content> in patients with cancer treated with zoledronate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content> increases with the duration of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> therapy, with notable differences observed with respect to <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> type and potency, route of administration and underlying disease. When data are stratified by <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> type, a time of 6.0 and 2.2\u00a0years of oral alendronate and intravenous zoledronate therapy, respectively, is required for 50% of patients to develop <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content>. After stratification by disease, a time of 5.3 and 2.2\u00a0years of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> therapy is required for 50% of patients with osteoporosis and cancer, respectively, to develop <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content>. These findings have significant implications for the design of future clinical studies and the development of risk\u2010reduction strategies aimed at either assessing or modulating the risk of <jats:styled-content style=\"fixed-case\">ONJ<\/jats:styled-content> associated with <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/odi.12632","type":"journal-article","created":{"date-parts":[[2016,12,31]],"date-time":"2016-12-31T13:26:39Z","timestamp":1483190799000},"page":"477-483","source":"Crossref","is-referenced-by-count":92,"title":["Time to onset of bisphosphonate\u2010related osteonecrosis of the jaws: a multicentre retrospective cohort study"],"prefix":"10.1111","volume":"23","author":[{"given":"PPL","family":"Fung","sequence":"first","affiliation":[{"name":"University College London\/University College London Hospital Eastman Dental Institute and Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Bedogni","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit Liver Research Centre Basovizza Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Bedogni","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery University of Verona Italy"},{"name":"Department of Maxillofacial Surgery University of Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Petrie","sequence":"additional","affiliation":[{"name":"University College London\/University College London Hospital Eastman Dental Institute and Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Porter","sequence":"additional","affiliation":[{"name":"University College London\/University College London Hospital Eastman Dental Institute and Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Campisi","sequence":"additional","affiliation":[{"name":"Dip. 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