title: The risk of bisphosphonate-related osteonecrosis of the jaw in children. A case report and literature review.
abstract: Bisphosphonate use has been described in children diagnosed with osteogenesis imperfecta (OI), fibrous dysplasia, neuromuscular disorders, bone dysplasia, idiopathic juvenile osteoporosis, rheumatologic disorder and even Crohn's disease. In OI patients, bisphosphonates have become an important symptomatic therapy for moderate and severe forms of the disease, because their inhibitory effect on osteoclasts increases bone mineralization and density, thereby reducing the risk of bone fractures. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) has become an increasingly common complication as the use of these drugs is becoming more widespread in adults. However, the evidence for BRONJ in paediatric patients is scarce. We present a case of a patient with OI on IV bisphosphonate therapy who required dental extractions and review the literature of the risk of BRONJ in this group of patients.
  
  
  CONCLUSIONS
  Dental clinicians need to be aware of the potential risk of BRONJ in paediatric patients who have had intravenous bisphosphonate therapy. It is important that these patients are identified and managed appropriately.
authors.affiliation: Dental Services, Kent Community Health NHS Trust.
authors.forename: Kwok-Kit
authors.initials: KK
authors.lastname: Ngan
authors.affiliation: Mid Western Regional Hopsital, Limerick, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Bowe
authors.affiliation: East Kent Hospitals University NHS Foundation Trust, UK.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Goodger
mesh_terms: D061605:Administration, Intravenous; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D003481:Cuspid / Q000601:surgery; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008963:Molar / Q000601:surgery; D010013:Osteogenesis Imperfecta / Q000188:drug therapy*; D010024:Osteoporosis / Q000188:drug therapy; D000077268:Pamidronate; D012307:Risk Factors; D014081:Tooth Extraction; D014094:Tooth, Deciduous / Q000601:surgery
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate