Osteonecrosis of the maxilla in a patient with a history of bisphosphonate therapy.
Bisphosphonates, which inhibit osteoclasts, alleviate many of the devastating consequences of metastatic bone disease. However, bisphosphonates may play a role in the development of osteonecrosis of the jaws. We report our experience in the management of a patient with a history of bisphosphonate therapy who presented with osteonecrosis of the jaws following dental extraction to make others, particularly the broader dental community, aware of this potential complication. We also review the pharmacologic properties of bisphosphonates and their possible role in the pathophysiology of osteonecrosis. Until more is known about the role of bisphosphonates in the development of osteonecrosis of the jaws, we recommend that measures be taken to prevent osteonecrosis in those at risk, including, when feasible, a dental consultation before initiating bisphosphonate therapy.
Melo
Maico D
MD
Department of Oral and Maxillofacial Surgery, Washington Hospital Center, Washington, DC 20010, USA. mmelo2@msn.com
Obeid
George
G
D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D003646:Debridement; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D008439:Maxillary Diseases / Q000139:chemically induced* / Q000601:surgery; D010020:Osteonecrosis / Q000139:chemically induced* / Q000601:surgery; D014081:Tooth Extraction / Q000009:adverse effects; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid