[Mandible osteonechrosis associated to bisfosfonates].
BACKGROUND
Mandibular osteonecrosis (MONC) is an entity associated with the use of powerful bisphosphonates with a prevalence of 1-10% in cancer patients


OBJECTIVE
To carry out a literature review with regard MONC, to establish the actual estate of this entity.


METHODS
A review of the literature up to September 18, 2007 was done via MEDLINE of the published articles on the topic. They following words were crossed: bisphosphonates, alendronate, clodronic acid, etidronate, ibandronate, risedronate, osteonecrosis, jaw. Atotal of 114 references were obtained and the best were chosen.


RESULTS
MONC presents in several ways: massive gingival edema without or with of necrotic bone exhibition in oral cavity accompanied by intense pain or asymptomatic. Symptoms can simulate common dental problems such as caries or periodontal illness. MONC can presents spontaneously or after a dental extraction. Several theories have been mentioned but at this moment any of them is completely satisfactory. The diagnosis is carried out mainly with based in history: age (7th life decade of), intravenous bisphosphonates use, long-term use of them, cancer, dental extraction and chemotherapy use. The treatment can be variable.


CONCLUSIONS
High power and long duration bisphosphonates are associated with a greater risk of MONC, although a narrow surveillance should be maintained in those used for osteoporosis treatment.
Carranza Lira
Sebastián
S
UMAE, Hospital de Ginecoobstetricia Luis Castelazo Ayala, IMSS, DF Mexico. scarranzal@mexis.com
D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D008334:Mandible / Q000473:pathology*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000473:pathology*
D004164:Diphosphonates