Dental implications of bisphophonate-related osteonecrosis

Sharon Saldanha, Vidya K. Shenoy, Prashanti Eachampati, Nakul Uppal

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Objectives: The aim is to explore the current theories about clinical, pathological and dental management of bisphosphonate related osteonecrosis of the jaws. Also discussed are the actions of bisphosphonates, pathogenesis related to the susceptibility of jaws, the predisposing risk factors for the development of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and diagnostic criteria based on the literature review. Discussion: Osteoporosis is a disease that generally affects the mineral status of both cortical and trabecular bone in post menopausal women. Bisphosphonates are a group of drugs that preserve and increase bone mass. Bisphosphonate drugs are classified according to use and method of delivery. The bisphosphonates used for the treatment of osteoporosis are taken orally. Little is known about the side effects and dangers of the long-term use of therapeutic doses of Bisphosphonates. A recent complication reported is osteonecrosis of jaws. The use of IV bisphosphonates for multiple myeloma and metastatic bone diseases suggests that dosage, length of treatment, and route of administration, as well as cofactors such as use of glucocorticoids and immunosuppressive agents, and dental surgery, could all be related to the incidence of BRONJ. This review provides an update on current knowledge about clinical, pathological and management aspects of BRONJ. Conclusions: Little evidence exists to direct the prosthodontic management of patients with a history of bisphosphonate use. Patients with active osteonecrosis related to bisphosphonate use have reduced tissue tolerance to function with removable prostheses and decreased potential for osseointegration of dental implants. Decisions should be based on clinical judgment tempered by the presenting conditions, medical profile, and patient needs. A better understanding would help in a dental setting to prevent any complication and help to improve the prognosis for those being treated for osteoradionecrosis.Until further evidence emerges regarding management of patients with active bisphosphonate- related osteonecrosis, conservative prosthodontic treatment is reasonable and prudent.

Original languageEnglish
Pages (from-to)177-187
Number of pages11
JournalGerodontology
Volume29
Issue number3
DOIs
Publication statusPublished - 01-09-2012

Fingerprint

Osteonecrosis
Diphosphonates
Bisphosphonate-Associated Osteonecrosis of the Jaw
Tooth
Prosthodontics
Jaw
Osteoporosis
Osteoradionecrosis
Osseointegration
Dental Implants
Bone Diseases
Therapeutic Uses
Immunosuppressive Agents
Multiple Myeloma
Causality
Pharmaceutical Preparations
Glucocorticoids
Prostheses and Implants
Minerals
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Dentistry(all)
  • Geriatrics and Gerontology
  • Ageing

Cite this

Saldanha, Sharon ; Shenoy, Vidya K. ; Eachampati, Prashanti ; Uppal, Nakul. / Dental implications of bisphophonate-related osteonecrosis. In: Gerodontology. 2012 ; Vol. 29, No. 3. pp. 177-187.
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Dental implications of bisphophonate-related osteonecrosis. / Saldanha, Sharon; Shenoy, Vidya K.; Eachampati, Prashanti; Uppal, Nakul.

In: Gerodontology, Vol. 29, No. 3, 01.09.2012, p. 177-187.

Research output: Contribution to journalReview article

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