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Care required when using bisphosphonates in dental surgical practice
Marcelo Coelho Goiato1, Daniela Micheline dos Santos, Bruna Carolina Santos Rondon
1Department of Dental Materials and Prosthodontics, University of the State of São Paulo, Brazil. goiato@foa.unesp.br
The Journal of Craniofacial Surgery
|December 2, 2010
Summary
Bisphosphonates treat bone conditions but can cause jaw osteonecrosis, especially with dental implants. This study details risks and precautions for healthcare professionals managing these patients.
Area of Science:
- Pharmacology
- Oral Surgery
- Bone Metabolism
Background:
- Bisphosphonates are bone-targeting drugs inhibiting osteoclast activity.
- They are primarily used for treating metabolic bone diseases.
- Bisphosphonate use is linked to osteonecrosis of the jaws (ONJ).
Purpose of the Study:
- To outline the risks associated with bisphosphonate therapy in patients undergoing dental implant surgery.
- To provide guidance on necessary precautions for healthcare professionals.
- To address the management of patients using bisphosphonates requiring surgical dental procedures.
Main Methods:
- Literature review on bisphosphonate effects on bone.
- Analysis of reported cases of ONJ in patients with dental implants.
- Clinical guidelines synthesis for managing bisphosphonate patients.
Main Results:
- Bisphosphonates significantly increase the risk of ONJ following invasive dental procedures.
- Osteoclast inhibition by bisphosphonates impairs bone healing and increases infection risk.
- Careful patient selection and management are crucial to mitigate ONJ risk.
Conclusions:
- Healthcare professionals must be aware of the ONJ risk in patients on bisphosphonates.
- Pre-operative assessment and tailored surgical planning are essential.
- Minimizing surgical trauma and optimizing oral hygiene can reduce complications.
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