title: Root canal therapy for the prevention of osteonecrosis of the  jaws: an evidence-based clinical update.
abstract: Osteonecrosis of the jaws is an adverse effect of bone preservation treatment. There is a sufficient body of evidence to associate osteonecrosis of the jaws development with dental extractions and trauma caused from ill-fitting dentures. In this review, we critically appraise available evidence about the clinical efficacy of root canal therapy in patients receiving bisphosphonates.We review a series of theories to explain why endodontic treatment is a safe clinical intervention to prevent osteonecrosis of the jaws in patients receiving bisphosphonates. Root canal therapy could postpone or even eradicate the need for dental extractions of carious teeth in patients on bisphosphonates who may develop osteonecrosis of the jaws. Patients receiving bisphosphonates should be offered the full range of preventive care to reduce their risk to both dental caries and periodontal disease, so that the need for both endodontic therapy and dental extractions will be reduced. Implementing such a strategy would require both practitioner and patient education through the combined efforts of medical and dental societies. Such an approach is justified, as the risk of compromising the oral health of patients on bisphosphonates undertaking endodontic treatment is negligible compared with the benefit from avoiding dental extractions.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece. akyrgidi@gmail.com
authors.forename: Athanassios
authors.initials: A
authors.lastname: Kyrgidis
authors.forename: Amit
authors.initials: A
authors.lastname: Arora
authors.forename: Kleoniki
authors.initials: K
authors.lastname: Lyroudia
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Antoniades
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D000069448:Denosumab; D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D056747:Immunomodulation / Q000187:drug effects; D007571:Jaw Diseases / Q000139:chemically induced / Q000517:prevention & control*; D009061:Mouth Mucosa / Q000187:drug effects; D010010:Osteoclasts / Q000187:drug effects; D010020:Osteonecrosis / Q000139:chemically induced / Q000517:prevention & control*; D053245:RANK Ligand / Q000009:adverse effects; D012390:Root Canal Therapy
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D053245:RANK Ligand; D000069448:Denosumab