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Bisphosphonates and osteonecrosis of the mandible/maxilla in osteoporosis: no reason to panic

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Abstract

Bisphosphonate (BP) therapy has modified the natural history of many bone metabolic diseases. Amino-bisphosphonates nowadays represent the primary therapeutic choice for the treatment of osteoporosis and for prevention of fractures.

Osteonecrosis of the mandible and maxilla (ONJ) is a rare disease usually occurring in cancer patients with bone metastases treated with high doses of intravenous BPs. Some cases have been described in patients taking amino-BPs for osteoporosis, but the specific drug utilized, its dosage and use of the oral route have reduced that risk considerably (estimated at 1/100,000 subjects a year).

Prevention of ONJ include good oral hygiene habits in all patients and, in a subject who has been treated for more than three years, conservative dental procedures when possible, an appropriate antibiotic therapy and a careful follow-up when invasive oral interventions are necessary, are recommended by dentists and bone metabolism experts alike.

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Authors and Affiliations

  1. Unit of Diseases of Mineral Metabolism and of the Bone, Department of Biomedical and Surgical Sciences, University of Verona, P.le Scuro 1, 37124, Verona, Italy

    Francesco Bertoldo MD

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  1. Francesco Bertoldo MD
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Correspondence to Francesco Bertoldo MD.

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Bertoldo, F. Bisphosphonates and osteonecrosis of the mandible/maxilla in osteoporosis: no reason to panic. Aging Clin Exp Res 20, 87–90 (2008). https://doi.org/10.1007/BF03324753

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