Association between osteonecrosis of the jaws and chronic high-dosage intravenous bisphosphonates therapy.
Bisphosphonates (BPs) are used to inhibit bone resorption. Recently, they have been used in cancer patients to prevent bone loss due to bone metastasis. Fourteen consecutive patients, undergoing BPs monthly IV infusion due to neoplastic bone diseases, were diagnosed with osteonecrosis of the jaws. None of the patients had been previously undergoing radiotherapy of the head and neck region. Eight patients showed maxillary involvement, and nine patients had had a recent tooth extraction in the osteonecrosis areas. Biopsies and surgical debridment were performed. Histologically, none of the patients showed signs of bone metastasis. As high-dosage long-term BP therapy appears to be associated with osteonecrosis of the jaws, dental practitioners should exercise caution in the treatment of such patients.
Graziani
Filippo
F
Department of Neurosciences, Section of Oral Surgery, University of Pisa, Pisa, Italy. f.graziani@med.unipi.it
Cei
Silvia
S
La Ferla
Fabio
F
Cerri
Elisa
E
Itro
Angelo
A
Gabriele
Mario
M
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced* / Q000628:therapy
D050071:Bone Density Conservation Agents; D004164:Diphosphonates