Bisphosphonate treatment: an orthodontic concern calling for a proactive approach.
The purpose of this article is to raise awareness among orthodontists of the effects of bisphosphonates, a commonly prescribed type of drug that can inhibit tooth movement and increase serious osteonecrosis risks in the alveolar bones of the maxilla and the mandible. Common medical uses of bisphosphonates, applicable pharmacology, pharmacokinetics, reports of impaired bone healing and induced osteonecrosis, and a drug effect accumulation theory are reviewed. Potential orthodontic issues and proposed orthodontic recommendations for intravenous and oral bisphosphonate treatments are discussed. Bisphosphonate medication screening, patient counseling, informed consent, and, perhaps, changes in treatment planning might be considered.
Zahrowski
James J
JJ
jzahrowski@aol.com
D000284:Administration, Oral; D000539:Alveolar Process / Q000187:drug effects; D000818:Animals; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000494:pharmacology; D016723:Bone Remodeling / Q000187:drug effects; D004164:Diphosphonates / Q000009:adverse effects* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007275:Injections, Intravenous; D007571:Jaw Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000517:prevention & control; D009970:Orthodontics / Q000379:methods*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000517:prevention & control; D011859:Radiography; D012307:Risk Factors; D013997:Time Factors; D014081:Tooth Extraction / Q000009:adverse effects; D014087:Tooth Movement Techniques
D050071:Bone Density Conservation Agents; D004164:Diphosphonates