Osteonecrosis of the jaw and bisphosphonate treatment for osteoporosis.
A potential side effect associated with bisphosphonates, a class of drugs used in the treatment of osteoporosis, Paget's disease and metastatic bone disease, is osteonecrosis of the jaw (ONJ). The incidence of ONJ in the general population is unknown; this rare condition also may occur in patients not receiving bisphosphonates. Case reports have discussed ONJ development in patients with multiple myeloma or metastatic breast cancer receiving bisphosphonates as palliation for bone metastases. These patients are also receiving chemotherapeutic agents that might impair the immune system and affect angiogenesis. The incidence or prevalence of ONJ in patients taking bisphosphonates for osteoporosis seems to be very rare. No causative relationship has been unequivocally demonstrated between ONJ and bisphosphonate therapy. A majority of ONJ occurs after tooth extraction. Furthermore, the underlying risk of developing ONJ may be increased in osteoporotic patients by comorbid diseases. Treatment for ONJ is generally conservative.
Rizzoli
René
R
University Hospital and Faculty of Medicine, Geneva, Switzerland. Rene.Rizzoli@medecine.unige.ch
Burlet
Nansa
N
Cahall
David
D
Delmas
Pierre D
PD
Eriksen
Erik Fink
EF
Felsenberg
Dieter
D
Grbic
John
J
Jontell
Mats
M
Landesberg
Regina
R
Laslop
Andrea
A
Wollenhaupt
Martina
M
Papapoulos
Socrates
S
Sezer
Orhan
O
Sprafka
Michael
M
Reginster
Jean-Yves
JY
D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000628:therapy; D010001:Osteitis Deformans / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000628:therapy; D010024:Osteoporosis / Q000188:drug therapy*; D012307:Risk Factors
D004164:Diphosphonates