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Author Spotlight: Insights into an Efficient Murine Maxillary Orthodontic Model Protocol
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Bisphosphonates: how to proceed in orthodontics

Marjolaine Tichit1,2, Sarah Gebeile-Chauty1,2

  • 1Unité Fonctionnelle d'Orthopédie Dento-Faciale, Centre de Traitements Dentaires, Hospices Civils de Lyon, 6-8 place Depéret, 69365 Lyon Cedex 03, France.

L' Orthodontie Francaise
|January 31, 2023
PubMed
Summary

Bisphosphonates hinder orthodontic tooth movement by inhibiting osteoclasts. While IV bisphosphonates are contraindicated for orthodontic treatment, oral bisphosphonates may be used cautiously with careful monitoring and patient informed consent regarding risks like delayed healing and osteonecrosis.

Keywords:
BisphosphonatesOrthodonticsOsteonecrosisGrowthOral surgeryDental implantNecrosis

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Area of Science:

  • Orthodontics
  • Pharmacology
  • Bone Biology

Background:

  • Bisphosphonates are widely used for osteoporosis and oncology, acting by inhibiting osteoclast activity and reducing bone remodeling.
  • This inhibition of bone remodeling can significantly impede orthodontic tooth movement.
  • Understanding the implications of bisphosphonate therapy is crucial for managing orthodontic patients.

Approach:

  • A comprehensive literature review was conducted using PubMed to identify relevant studies.
  • The search focused on indications and therapeutic strategies for orthodontic treatment in patients using bisphosphonates.
  • A decision-making framework for managing these patients was proposed.

Key Points:

  • Intravenous bisphosphonate therapy is a contraindication for orthodontic treatment.
  • Oral bisphosphonate use requires collaboration with the prescribing physician, avoidance of invasive procedures, and awareness of potential complications.
  • Risks include slowed tooth movement, delayed healing, and osteonecrosis, necessitating vigilant clinical and radiographic monitoring.

Conclusions:

  • The current literature on bisphosphonates in orthodontics is of low grade, with many studies based on animal models.
  • Ongoing research is exploring the potential of bisphosphonates as orthodontic anchorage reinforcement.
  • Careful risk-benefit assessment and patient communication are paramount when considering orthodontic treatment for patients on bisphosphonates.