[Osteonecrosis of the jaw developing during bisphosphonate treatment].
The article discusses osteonecrosis of the jaw as a possible side effect of bisphosphonate treatment. It provides practical guidelines for prevention, diagnosis and management of bisphosphonate-associated osteonecrosis according to literature and clinical evidence. Since controlled clinical trials have not been carried out, the recommendations are based on reviews, reports and clinical experience. Osteonecrosis of the jaw (ONJ) is a historical clinical entity, which can potentially develop in cancer patients receiving bisphosphonate therapy. The pathogenesis of ONJ has not been totally revealed yet. A thorough dental/oral surgical examination and counseling is recommended in cases when intravenous bisphosphonate therapy is needed. All required dental and surgical treatment should be carried out before starting bisphosphonate therapy to prevent ONJ. The patient should be informed about the possible side effects, and the importance of good oral home care and regular dental check-ups. Once the intravenous bisphosphonate therapy has started, only conservative manipulations should be carried out in the oral cavity. Even in case of developed ONJ, suspension of bisphosphonate therapy is not necessary. In these cases a non-surgical approach is recommended concerning the treatment of ONJ. Regarding the growing number of ONJ cases in association with bisphosphonate therapy it is important for the professionals treating cancer patients to be aware of this phenomenon and the importance of prevention.
Udvardy
Eniko
E
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Fogorvosi Kar, Arc-, Allcsont- és Szájsebészeti Osztály, Debrecen. enikoudvardy@gmail.com
Redl
Pál
P
Márton
Ildikó
I
D019386:Alendronate / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D016723:Bone Remodeling / Q000187:drug effects*; D004002:Clodronic Acid / Q000009:adverse effects; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D012968:Etidronic Acid / Q000009:adverse effects; D006801:Humans; D000077557:Ibandronic Acid; D007093:Imidazoles / Q000009:adverse effects; D008334:Mandible / Q000187:drug effects / Q000473:pathology; D008336:Mandibular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D009910:Oral Hygiene; D019647:Oral Surgical Procedures; D010020:Osteonecrosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D010348:Patient Care Team; D012017:Referral and Consultation; D000077211:Zoledronic Acid
D000890:Anti-Infective Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D004002:Clodronic Acid; D000077211:Zoledronic Acid; D012968:Etidronic Acid; D000077557:Ibandronic Acid; D019386:Alendronate