Bisphosphonate induced osteochemonecrosis of the jaws: an ounce of prevention may be worth a pound of cure

John W Hellstein; Cindy L Marek

doi:10.1111/j.1754-4505.2006.tb01503.x

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Bisphosphonate induced osteochemonecrosis of the jaws: an ounce of prevention may be worth a pound of cure

Journal article

Peer reviewed

Bisphosphonate induced osteochemonecrosis of the jaws: an ounce of prevention may be worth a pound of cure

John W Hellstein and Cindy L Marek

Special care in dentistry, Vol.26(1), pp.8-12

01/2006

DOI: 10.1111/j.1754-4505.2006.tb01503.x

PMID: 16703928

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Abstract

Patient exposure to bisphosphonate drugs for the management of hypercalcemia of malignancy, osteolytic lesions of metastatic cancer and osteoporosis has led to increasing reports of osteochemonecrosis of the jaws (bis-phossy jaw). This serious and debilitating condition requires dental practitioners to be alert for signs and symptoms of this syndrome. Thus far, nitrogen containing bisphosphonates have been implicated as a causative agent. While only a small fraction of patients who have taken these agents will develop osteochemonecrosis, it seems that patients who have received intravenous bisphosphonates are at greater risk than those who have taken oral agents. Tooth extractions are the most frequently reported predisposing dental procedure. While appropriate management strategies for patients with osteochemonecrosis of the jaws are evolving, we are suggesting rational preventive protocols and therapies based upon current experience and knowledge. These recommendations may change over time as the profession gains more experience in managing these patients.

Injections, Intravenous

Bone Density Conservation Agents - adverse effects

Osteoporosis - prevention & control

Administration, Oral

Humans

Jaw Diseases - prevention & control

Diphosphonates - administration & dosage

Bone Density Conservation Agents - administration & dosage

Nitrogen

Dental Care for Chronically Ill

Risk Management

Jaw Diseases - chemically induced

Anti-Bacterial Agents - therapeutic use

Antineoplastic Agents - adverse effects

Diphosphonates - chemistry

Bone Neoplasms - drug therapy

Osteonecrosis - chemically induced

Osteonecrosis - prevention & control

Diphosphonates - adverse effects

Bone Density Conservation Agents - chemistry

Details

Title: Subtitle: Bisphosphonate induced osteochemonecrosis of the jaws: an ounce of prevention may be worth a pound of cure
Creators: John W Hellstein - University of Iowa, USA. john-hellstein@uiowa.edu
Cindy L Marek
Resource Type: Journal article
Publication Details: Special care in dentistry, Vol.26(1), pp.8-12
Publisher: United States
DOI: 10.1111/j.1754-4505.2006.tb01503.x
PMID: 16703928
ISSN: 0275-1879
eISSN: 1754-4505
Language: English
Date published: 01/2006
Academic Unit: Oral Pathology, Radiology and Medicine; Pharmacy Practice and Science
Record Identifier: 9984065500402771

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