title: Bisphosphonate-related osteonecrosis of the jaws: a case series of 25 patients affected by osteoporosis.
abstract: Bisphosphonates (BPs) are used to treat metabolic bone diseases, such as osteoporosis. In this study the occurrence of bisphosphonates-related osteonecrosis of the jaws (BRONJ) is reported in 25 patients who received BP therapy for osteoporosis with different drug schedules. From June 2005 to May 2009, 25 patients affected by BRONJ were observed. A history of oral surgery was reported for 18 patients (72%). Of the 22 patients treated by the authors, 20 (91%) recorded healing improvement with a mean follow-up of 16.6 months, with particular regard for those treated with oral surgery and laser applications (10/22, 45%) who were all characterised by complete mucosal healing over time. The risk of developing BRONJ in patients treated with BP for osteoporosis is lower than in cancer patients, but is not negligible. It is advisable for the prescribing physician to recommend a dental check-up prior to treatment, at least for patients who have not been to the dentist in the last 12 months. An early surgical and possible laser-assisted approach for patients who develop BRONJ is recommended.
authors.affiliation: Oral Medicine, Oral Pathology and Laser Assisted Surgery Unit, University of Parma, Italy. maddalena.manfredi@unipr.it
authors.forename: M
authors.initials: M
authors.lastname: Manfredi
authors.forename: E
authors.initials: E
authors.lastname: Merigo
authors.forename: R
authors.initials: R
authors.lastname: Guidotti
authors.forename: M
authors.initials: M
authors.lastname: Meleti
authors.forename: P
authors.initials: P
authors.lastname: Vescovi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003475:Curettage; D003646:Debridement; D003729:Dental Care; D015921:Dental Implants; D003778:Dentures; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000628:therapy; D053685:Laser Therapy; D028022:Low-Level Light Therapy / Q000379:methods; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced* / Q000628:therapy; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D010347:Patient Care Planning; D012307:Risk Factors; D014081:Tooth Extraction; D014945:Wound Healing / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D015921:Dental Implants; D004164:Diphosphonates; D004338:Drug Combinations; D005938:Glucocorticoids