Bisphosphonates and bisphosphonate induced osteonecrosis.
Bisphosphonate-induced osteonecrosis of the jaws is the correct term for this real drug complication that most dental practitioners face. All nitrogen-containing bisphosphonates pose a risk, which is related to the route of administration, the potency of the bisphosphonate, and the duration of use. Although intravenous bisphosphonate-induced osteonecrosis of the jaws is mostly permanent, most cases can be prevented or managed if they develop, with only a few cases requiring resection for resolution. Oral bisphosphonate-induced osteonecrosis of the jaws also can be prevented with knowledge of the risk level related to the duration of use and the C-terminal telopeptide blood test results. Most cases can be resolved with a drug holiday either spontaneously or via straightforward débridement.
Sawatari
Yoh
Y
Division of Oral and Maxillofacial Surgery, University of Miller Miami School of Medicine, 9380 SW 150th Street, Miami, FL 33157, USA. ysawatari@med.miami.edu
Marx
Robert E
RE
D000284:Administration, Oral; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D024042:Collagen Type I / Q000097:blood; D003646:Debridement; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007275:Injections, Intravenous; D007571:Jaw Diseases / Q000139:chemically induced* / Q000517:prevention & control; D010020:Osteonecrosis / Q000139:chemically induced* / Q000517:prevention & control; D010455:Peptides / Q000097:blood; D012307:Risk Factors; D013997:Time Factors
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide