Lower jaw osteonecrosis associated with bisphosphonates.
DOI:
https://doi.org/10.35954/SM2023.42.1.7.e402Keywords:
Diphosphonates, Mandible, Maxilla, Dentistry, Osteonecrosis, Bisphosphonate-Associated Osteonecrosis of the JawAbstract
Introduction: Given the high prescription of bisphosphonates, we present their adverse effects in the dental sphere, being an infrequent complication, but difficult to treat. There is no need to suspend treatment, given the important benefit in terms of prevention of fragility fractures. These fractures cause high morbimortality as opposed to the low risk associated with bisphosphonate-associated osteonecrosis of the jaw.
Objective: To orient the health personnel who handle these drugs and who assist these complications to have knowledge for the prevention of osteonecrosis. To identify and differentiate patients at higher risk, according to the dose of bisphosphonates and frequency of treatment.
Materials and Method: A literature review was performed in the following sources: Scielo, Google academic, Medline/Pubmed, Virtual Health Library (Brazil), from 2005 to date, Spanish, Portuguese and English languages. The descriptors used were bisphosphonates, mandible, maxilla, dentistry, osteonecrosis, osteonecrosis of the jaws associated with bisphosphonates.
Results: The latest treatment guidelines were modified in 2014, by consensus of the American Association of Oral and Maxillofacial Surgery. The pathogenesis of bisphosphonate-associated maxillary osteonecrosis is not completely defined, although publications try to explain it. The risk of developing it by oral therapy is lower than by intravenous administration. Discussion: The physician who prescribes the antiresorptive drug should know the dental health status of his patient and, if possible, refer him for examination by a dentist before initiating bisphosphonate therapy.
Received for evaluation: September 2022.
Accepted for publication: February 2023.
Correspondence: Grupo "Las Piedras" de artillería 105 mm Nº 3. General Manuel Oribe 502. Paso de los Toros, Tacuarembó, Uruguay. Tel: (+598) 4664 2235 - Fax: 4664 2374.
E-Mail contact: gpoa3@ejercito.mil.uy
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