title: [Risk assessment in patients undergoing osseous antiresorptive therapy in dentistry. An update].
abstract: Antiresorptive therapy is prescribed in particular for the treatment of osteoporosis as well as for the treatment of tumor-induced hypercalcemia and metastatic bone disease. As a consequence, osteopathologies such as bisphosphonate-related osteonecrosis of the jaws (BRONJ) may occur. In 2008, our department reported on BRONJ in a paper that provided dental clinicians with information on diagnostics, therapy, and prevention (Dannemann et al., Schweizer Monatsschrift für Zahnmedizin, Vol. 118, 2/2008). During the last 8 years, new findings have emerged concerning potential etiologies, modes of therapy, and the use of additional antiresorptive therapies. For example, an important point for colleagues in dental practice is the now common intravenous administration of bisphosphonates in osteoporosis patients, which may lead to uncertainty when assessing risk in these patients. For this reason, this article provides an update of the above mentioned publication and gives dental clinicians an updated guideline concerning risk assessment in patients undergoing antiresorptive therapy. In this context, a risk assessment algorithm is presented. The pathogenesis, diagnosis, therapy, and prevention of BRONJ and oral implantation in patients receiving antiresorptive therapy are addressed with regard to the current literature. Finally, we present two example cases.
authors.affiliation: Poliklinik für Orale Chirurgie Zentrum für Zahnmedizin Universität Zürich, Zürich, Switzerland.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Borm
authors.forename: Stephanie
authors.initials: S
authors.lastname: Moser
authors.forename: Michael
authors.initials: M
authors.lastname: Locher
authors.forename: Georg
authors.initials: G
authors.lastname: Damerau
authors.forename: Bernd
authors.initials: B
authors.lastname: Stadlinger
authors.forename: Klaus W
authors.initials: KW
authors.lastname: Grätz
authors.forename: Christine
authors.initials: C
authors.lastname: Jacobsen
mesh_terms: D000368:Aged; D019386:Alendronate / Q000009:adverse effects; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D001862:Bone Resorption / Q000188:drug therapy*; D000075202:Contraindications; D015921:Dental Implants; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy; D010024:Osteoporosis / Q000188:drug therapy; D057873:Peri-Implantitis / Q000209:etiology; D018570:Risk Assessment
chemical_list: D050071:Bone Density Conservation Agents; D015921:Dental Implants; D004164:Diphosphonates; D019386:Alendronate