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Bisphosphonates--a word of caution.
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University Hospital, Singapore. omsnar@nus.edu.sg
Annals of the Academy of Medicine, Singapore
|September 25, 2004
Summary
Bisphosphonates, commonly prescribed drugs, may be linked to avascular necrosis of the jaws. This review highlights this potential oral cavity adverse reaction for clinical awareness.
Area of Science:
- Oral medicine
- Pharmacology
- Oncology
Background:
- Bisphosphonates are widely used for osteoporosis and bone metastases.
- Recent case reports suggest a link between bisphosphonate use and jaw osteonecrosis.
- This condition, known as bisphosphonate-related osteonecrosis of the jaw (BRONJ), is a growing concern.
Purpose of the Study:
- To review the current literature on the association between bisphosphonates and avascular necrosis of the jaws.
- To alert clinicians to this potential adverse drug reaction.
- To provide guidance on patient management and prevention.
Main Methods:
- Literature review of case reports, clinical studies, and expert opinions.
- Analysis of proposed pathogenetic mechanisms.
- Discussion of clinical implications and recommendations.
Main Results:
- Evidence suggests a correlation between bisphosphonate therapy and jaw osteonecrosis.
- Risk factors and potential mechanisms are discussed.
- The incidence and severity of BRONJ appear to be related to drug dosage and duration of therapy.
Conclusions:
- Bisphosphonate therapy may pose a risk for developing avascular necrosis of the jaws.
- Clinicians should be vigilant for signs and symptoms of BRONJ in patients receiving bisphosphonates.
- Further research is needed to elucidate the exact pathophysiology and optimize management strategies.