Download PDF
CC BY-NC-ND 4.0 · European Journal of General Dentistry 2014; 3(01): 11-16
DOI: 10.4103/2278-9626.126202
Review Article

Bisphosphonates and the field of dentistry

Farzeen Tanwir
Department of Periodontology, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
,
Ali Abid Mirza
Department of Periodontology, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
,
Dania Tauseef
1   Adamjee Insurance Corporation Ltd., Karachi, Pakistan
,
Amber Mahar
Department of Periodontology, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
› Author Affiliations
› Further Information
  PDF Download Permissions and Reprints

Abstract

Bisphosphonates are the drugs used to prevent loss of bone and to treat bone diseases and conditions that feature bone fragility. Bisphosphonates, according to the potency levels, are divided into three generations and potency levels have increased with successive generations and, according to mechanism of action, they are divided into Non-nitrogenous and Nitrogenous bisphosphonates. Clinically, nitrogen containing bisphosphonates are more potent. Oral bisphosphonates are safer than intravenous infusion. Oral bisphosphonates may cause recurrent ulcers with burning sensation and blisters in the oral cavity, while intravenous bisphosphonates may cause renal failure. The most serious complication of intravenous bisphosphonates is osteonecrosis of jaw bones especially after tooth extraction. Endodontic therapy is not a significant risk factor for promoting bisphosphonates-related osteonecrosis, so endodontic therapy can be an alternative to tooth extraction when possible. Regarding treatment, parathyroid hormone can be helpful because it stimulates bone formation by promoting bone turnover.

Keywords

Bisphosphonates - dentistry - osteonecrosis - pamidronate - zoledronic acid


Publication History

Article published online:
01 November 2021

© 2014. European Journal of General Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Sharma D, Ivanovski S, Slevin M, Hamlet S, Tudor S, Brinzaniuc K, et al. Bisphosphonate-related osteonecrosis of jaw (BRONJ): diagnostic criteria and possible pathogenic mechanisms of an unexpected anti-angiogenic side effect. Vasc Cell 2013;
  • 2 Kleio P, Cartsos V, Athanasios I. Bisphsphonates and time to osteonecrosis development. Oncologist 2009;14:1154-66.
  • 3 Rastogi A, Rattan V, Kumar S. Osteonecrosis of jaw associated with bisphosphonate use. Indian J Endocrinol Metab 2012;16:450-52.
  • 4 Peter R. Bisphosphonates-clinical applications in osteoporosis. Aust Prescr 2000;23:133-6.
  • 5 Tanvetyanon T, Stiff PJ. Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol 2006;17:897-907.
  • 6 Rakel A, Boucher A and Georges L. Role of zoledronic acid in the prevention and treatment of osteoporosis. Clin Interv. Aging 2011; 6:89-99.
  • 7 Gregg S. Intravenous bisphosphonate therapy and inflammatory conditions or surgery of the jaw: A population-based analysis. Oxford University Press 2008;100:155-6.
  • 8 Peterson JD, Bedrossian EH. Bisphosphonate-associated orbital inflammation: A case report and review. Orbit 2012;31:119-23.
  • 9 Kaur H, Uy C, Kelly J, Moses AM. Orbital inflammatory disease in a patient treated with zoledronate. Endocr Pract 2011;17:101-3.
  • 10 Lippuner K. Medical treatment of vertebral osteoporosis. Eur Spine J 2003;12:132-41.
  • 11 Haumschild S, Ryan J. Postmenopausal females and the link between oral bisphosphonates and osteoporosis of the jaw: A clinical review. J Am Acad Nurse Pract 2010;22:534-9.
  • 12 Sarasquete M, Gonzalez M, San JF, Garcia R. Bisphosphonate-related osteonecrosis: Genetic and acquired risk factors. Oral Dis 2009;15:382-7.
  • 13 Assael LA. Oral bisphosphonates as a cause of bisphosphonate-related osteonecrosis of the jaws: Clinical findings, assessment of risks, and preventive strategies. J Oral Maxillofac Surg 2009;67 (5 suppl):35-43.
  • 14 Zadik Y, Lehman H, Neuman T and Benoliel R. Primary lymphoma of the mandible masquerading as bisphosphonate-related osteonecrosis of jaws. Quintessence Int 2012;43:769-75.
  • 15 Moinzadeh A, Shemesh H, Neirynck N, Aubert C, Wesselink P. Bisphosphonates and their clinical implications in endodontic therapy. Int Endod J 2013;46:391-8.
  • 16 Mawardi H, Giro G, Kajiya M, Ohta K, Almazrooa S, Kawai T, et al. A role of oral bacteria in bisphosphonate-induced osteonecrosis of jaw. Available from: http://jdr.sagepub.com/supplemental [Last accessed on 2013 Mar 13].
  • 17 Mozzati M, Arata V, Gallesio G. Tooth extraction in osteoporotic patients taking oral bisphosphonates. Osteoporos Int 2013;24:1707-12.
  • 18 Gupta R. Early dental implant failure in patient associated with oral bisphosphonates. Indian J Dent Res 2012;23:298.
  • 19 Bedogni A, Bettini G, Totola A, Saia G, Nocini PF. Oral bisphosphonate-associated osteonecrosis of the jaw after implant surgery: A case report and literature review. J Oral Maxillofac Surg 2010;68:1662-6.
  • 20 Iglesias-Linares A, Yáñez-Vico RM, Solano-Reina E, Torres-Lagares D, González Moles MA. Influence of bisphosphonates in orthodontic therapy: Systemic review. J Dent 2010;38:603-11.
  • 21 Kumar AR, Sawhney C, Kumar S, Dhingra M. Bisphosphonates related osteonecrosis of the jaws: An update. Eur J Gen Dent 2012;3:131-6.
  • 22 Li YF, Hu J. Parathyroid hormone may be a promising therapy for bisphosphonate-related osteonecrosis of jaw bones. Int J Oral Maxillofac Surg 2013;42:149-50.
  • 23 Farrugia MC, Summerlin DJ, Krowiak E, Huntley T, Freeman S, Borrowdale R, et al. Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates. Laryngoscope 2006;116:115-20.
  • 24 Faloni AP, Queiroz TP, Comelli RC, Cerri PS, Margonar R, Rastelli AN, et al. Accurate approach in the treatment of oral bisphosphonate-related jaw osteonecrosis. J Craniofac Surg 2011;22:2185-90.