Bisphosphonates and osteonecrosis of the jaws: science and rationale.
Bisphosphonates as a group of drugs were introduced for the management of various conditions such as osteoporosis, Paget's disease, multiple myeloma, hypercalcemia of malignancy, breast cancer, prostate cancer, and other tumors. This group of drugs has improved the quality of life in many patients with proven efficacy in limiting pain and skeletal-related events. The controversy of osteonecrosis of the jaws and bisphosphonates is a recent and growing problem. Osteonecrosis of the jaws is recognized as a serious complication of bisphosphonate therapy, more commonly with the intravenous form of the drugs. However, there is limited scientific understanding about the association between osteonecrosis of the jaws and bisphosphonates. In the present article we discuss various mechanisms of action of bisphosphonates, the rationale for occurrence of osteonecrosis in the jaws, and treatment guidelines for the condition.
Gutta
Rajesh
R
Oral and Maxillofacial Surgery, University of Alabama, Birmingham, AL, USA. rajeshg@uab.edu
Louis
Patrick J
PJ
D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000737:chemistry; D000075202:Contraindications; D004164:Diphosphonates / Q000009:adverse effects* / Q000737:chemistry; D015195:Drug Design; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D019647:Oral Surgical Procedures; D010020:Osteonecrosis / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control
D050071:Bone Density Conservation Agents; D004164:Diphosphonates