Endodontic implications of bisphosphonate-associated osteonecrosis of the jaws: a report of three cases.
Bisphosphonates are commonly used in medicine to maintain bone density in patients with certain nonneoplastic diseases or cancers. A serious adverse effect of bisphosphonates that has substantial dental significance is osteonecrosis that appears to uniquely affect the mandible and maxilla without occurring in other bones of the skeleton. Patients with bisphosphonate associated osteonecrosis of the jaws may present with pain and exposed necrotic bone. This has substantial clinical implications because surgical procedures (including extractions or endodontic surgical procedures) are contraindicated in the jaws of these patients and the presenting pain may mimic pain of odontogenic origin. This report describes three patients with bisphosphonate associated osteonecrosis and emphasizes the endodontic implications of managing these patients.
Katz
Harmon
H
Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA. docendo1@aol.com
D000368:Aged; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D003731:Dental Caries / Q000628:therapy; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000139:chemically induced*; D008439:Maxillary Diseases / Q000139:chemically induced*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced*; D011471:Prostatic Neoplasms / Q000188:drug therapy; D011671:Pulpitis / Q000628:therapy; D014081:Tooth Extraction / Q000009:adverse effects
D050071:Bone Density Conservation Agents; D004164:Diphosphonates