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A Novel in vivo Gene Transfer Technique and in vitro Cell Based Assays for the Study of Bone Loss in Musculoskeletal Disorders
Published on: June 8, 2014
[Osteoporosis, bisphosphonates and jaws osteochemonecrosis]
1Service de Stomatologie et de Chirurgie Maxillo-Faciale, Hôpital Erasme, Bruxelles. michele.magremanne@ulb.ac.be
Revue Medicale De Bruxelles
|October 28, 2008
Summary
Bisphosphonates treat bone diseases but can cause jaw osteonecrosis, especially with IV use after 3 years. Preventive dental care before starting bisphosphonate therapy is crucial.
Area of Science:
- Oncology
- Endocrinology
- Dentistry
Background:
- Bisphosphonates are crucial for treating osteoporosis, Paget's disease, and cancers with bone involvement.
- Medication-related osteonecrosis of the jaw (MRONJ) is a known adverse effect, particularly with intravenous bisphosphonates.
- Risk increases with treatment duration, often exceeding three years, and invasive dental procedures can trigger it.
Purpose of the Study:
- To highlight the risk of jaw osteonecrosis associated with bisphosphonate therapy.
- To emphasize the importance of oral health management in patients undergoing bisphosphonate treatment.
- To inform clinical practice regarding bisphosphonate prescription and patient monitoring.
Main Methods:
- Review of clinical literature and case reports on bisphosphonate-induced osteonecrosis of the jaw.
- Analysis of risk factors, including drug formulation (oral vs. intravenous) and treatment duration.
- Evaluation of preventative and management strategies for jaw osteonecrosis.
Main Results:
- Jaw osteonecrosis is a significant complication, more prevalent with intravenous bisphosphonates.
- Long-term bisphosphonate use (over 3 years) elevates the risk.
- Tooth extraction and invasive dental procedures are common precipitating factors.
Conclusions:
- Bisphosphonates require careful patient selection and oral health assessment prior to initiation.
- Proactive dental care, including necessary treatments before starting bisphosphonates, is essential for mitigating MRONJ risk.
- Currently, no definitive treatment exists for established bisphosphonate-related osteonecrosis of the jaw, underscoring the importance of prevention.
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