Bisphosphonate-associated Osteonecrosis of the jaws: a guide for the general dental practitioner.
Bisphosphonates are used most commonly in the management of metastatic malignant disorders to bone and for osteoporosis. The number of patients on treatment is increasing. Although there is clear evidence of medical efficacy, there are increasing numbers of reports concerning bisphosphonate-associated osteonecrosis of the jaws. This side-effect poses significant problems and is very difficult to treat. The aim of this article is to outline the proposed pathogenesis, incidence, presenting signs and symptoms, and risk factors. Also, suggestions are made as to the most appropriate measures for prevention and management of bisphosphonate-associated jaw osteonecrosis.


CONCLUSIONS
General dental practitioners have a key role to play in identifying patients at risk of developing bisphosphonate-associated osteonecrosis of the jaws, preventing occurrence of the condition and initiating early specialist referral.
Barker
Kate
K
University Hospital Aintree, Longmoor Lane, Liverpool, UK.
Rogers
Simon
S
D000700:Analgesics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D005157:Facial Pain / Q000517:prevention & control; D017408:Guidelines as Topic; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced*; D010019:Osteomyelitis / Q000517:prevention & control; D010020:Osteonecrosis / Q000139:chemically induced*; D014081:Tooth Extraction / Q000009:adverse effects
D000700:Analgesics; D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates