[Treatment of common osteoporosis with fluoride: current trends]

The pharmacology of fluoride is reviewed. Efficacy criteria of sodium fluoride in osteoporosis are analysed. An increase in bone mass of the order of 8 per cent per year is seen in 60-70 per cent of osteoporotics whether evaluated by histomorphometry or by bone densitometry in double-blind controlled trials. Fluoride has no effect on bone mass in 30 to 40 per cent of osteoporotics. The reason(s) for such resistance is/are not fully understood. It is not possible at present to state that there is a decrease in the incidence of vertebral fractures on the basis of data from double-blind trials. The incidence of bone fissures affecting the bones of the lower limbs is significantly increased in osteoporotics treated with fluoride, above all if doses of elemental fluoride are greater than 25 mg or in the presence of unrecognised renal insufficiency. The incidence of these fissures is of the order of 20 to 30 per cent.