[Extensive osteonecrosis of the jaws associated with biphophonates therapy].
OBJECTIVE
The purpose of this study was to present the risk of occurrence of osteonecrosis of the jaws during bisphosphonate therapy and to evaluate their involvement.


METHODS
We report our experience from 2004 to 2005 in the management of three cases of osteonecrosis of the jaws occurring in patients cured by bisphosphonates for metastatic bone disease. Dental extractions preceded the appearance of symptoms for two of the three cases.


RESULTS
Bisphosphonates, which inhibit osteoclasts, reduce a great number of the devastating consequences of the metastatic bone disease. Cases of osteonecrosis of the jaw (ONJ) have been reported with a significant increase over the past few years. Bisphosphonates have been used for several decades to reduce the effects of bone metastasis and osteoporosis. However, they seem to play a part in the appearance of the osteonecrosis of the jaws. We studied the pharmacological features of the bisphosphonates and the role they can play in the physiopathology of osteonecrosis.


CONCLUSIONS
Osteonecrosis of the jaws is an uncommon complication of bisphosphonate treatment. Dental care is recommended for every high-risk patient before the beginning bisphosphonate treatment, although total prophylaxis is impossible.
Rattin
C
C
Service d'orl et de chirurgie cervicofaciale, Fondation Hôtel-Dieu, 175, rue Maréchal-Foch, 71200 Le Creusot, France. christian.rattin@wanadoo.fr
Vanoli
A
A
Latombe
I
I
D000368:Aged; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D004164:Diphosphonates