Can bisphosphonates cause osteonecrosis?

Recently, however, high-dose intravenous bisphosphonates have been identified as a risk factor for osteonecrosis of the jaw among oncology patients. Low-dose bisphosphonate use in patients with osteoporosis or other metabolic bone disease has not been causally linked to the development of osteonecrosis of the jaw.

What is bisphosphonate induced osteonecrosis?

Introduction. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a chronic condition of the oral cavity resulting in mucosal ulceration and exposure of underlying necrotic bone, and the ensuing secondary complications. As a relatively newly recognised condition, the epidemiology of BRONJ is poorly described.

How is osteonecrosis of the jaw treated?

Osteonecrosis of the jaw is usually treated with antibiotics, oral rinses, and removable mouth appliances (retainers). Because osteonecrosis of the jaw is rare, doctors can’t predict who will develop it. If you’re taking a bisphosphonate, tell your dentist right away.

Do bisphosphonates cause avascular necrosis?

Infrequent side effects associated with bisphosphonate use include pyrexia, renal function impairment, hypocalcemia, and, more recently recognized, avascular osteonecrosis of the jaw.

Can osteonecrosis of the jaw be fatal?

Even if a negative impact on Quality of Life has been described and demonstrated, ONJ is usually described as an event with mild or moderate sereneness. However, as a form of osteomyelitis with potential severe complications, ONJ can rarely be life-threatening.

What kind of doctor treats osteonecrosis of the jaw?

Once established, osteonecrosis of the jaw is challenging to treat and should be managed by an oral surgeon with experience treating ONJ. Treatment of ONJ typically involves limited debridement, antibiotics, and antibacterial oral rinses (eg, chlorhexidine; 1 ).

What does osteonecrosis of the jaw look like?

ONJ looks like an area of exposed bone in your mouth. It can cause tooth or jaw pain and swelling in your jaw. Severe symptoms include infection in your jaw bone. You can get ONJ after some dental surgeries, such as getting teeth extracted (removed) or implanted.

How do you diagnose osteonecrosis of the jaw?

To diagnose osteonecrosis of the jaw, doctors may use x-rays or other radiology. Treatments for osteonecrosis of the jaw may include antibiotics, pain relief medication or oral rinses. Minor dental work may be necessary to remove injured tissue and reduce sharp edges of the bone.

What are the signs of osteonecrosis of the jaw?

What are the symptoms of ONJ?

• pain or swelling in the mouth.
• non-healing of a tooth socket after removal of teeth.
• loosening of teeth.
• an area of exposed bone in the mouth.
• poor healing or infection of the gums.
• numbness or the feeling of heaviness in the jaw.
• discharge of pus.

What are signs of osteonecrosis of the jaw?

How fast does osteonecrosis of the jaw progress?

Osteonecrosis of the jaw is diagnosed when exposed, necrotic bone is present in the maxilla or mandible for at least 8 weeks.

How are bisphosphonates used to treat osteoporosis?

Bisphosphonates are used worldwide as a successful treatment for people with osteoporosis, which is the major underlying cause of fractures in postmenopausal women and older adults. These agents are successful at increasing bone mass and bone trabecular thickness, decreasing the risk of fracture, an … Bisphosphonates and osteonecrosis of the jaw

Who is at a higher risk for bisphosphonates?

Patients with intravenous bisphosphonate and malignant disease are at a higher risk compared to patients with oral BP and benign diseases [6–12]. Alendronate, risedronate, and ibandronate are commonly administered orally to treat osteoporosis and osteopenia in postmenopausal women [13].

What is the bioavailability of oral bisphosphonates?

Oral BPs have a bioavailability of less than 5%. 12 Once in the blood, BPs disappear very rapidly into the bone. 13 After BPs are buried in the skeleton, they are released only when the bone is destroyed in the course of turnover. In humans, the skeletal half-lives of various BPs range from 3 months to as long as 10 years. 14

What to do for ONJ with bisphosphonates?

During bisphosphonate treatment, patients should maintain good oral hygiene, receive routine dental check-ups, and report any oral symptoms such as dental mobility, pain, or swelling The risk of ONJ with bisphosphonates will be kept under close review in Europe.