Mechanism, prevention, risk assessment and treatment in bisphosphonates induced osteonecrosis of the jaw

Jung-Chul Park; Ui-Won Jung; Chang-Sung Kim; Kyoo-Sung Cho; Jung-Kiu Chai; Chong-Kwan Kim; Seong-Ho Choi

doi:10.5051/jkape.2009.39.1.1

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Park, Jung, Kim, Cho, Chai, Kim, and Choi: Mechanism, prevention, risk assessment and treatment in bisphosphonates induced osteonecrosis of the jaw

Review Article

The Journal of the Korean Academy of Periodontology

The Journal of the Korean Academy of Periodontology 2009; 39(1): 1-8.

Published online: 31 March 2009

DOI: https://doi.org/10.5051/jkape.2009.39.1.1

Mechanism, prevention, risk assessment and treatment in bisphosphonates induced osteonecrosis of the jaw

Jung-Chul Park, Ui-Won Jung, Chang-Sung Kim, Kyoo-Sung Cho, Jung-Kiu Chai, Chong-Kwan Kim, Seong-Ho Choi

Department of Periodontology, Research institute of periodontal regeneration, College of Dentistry, Yonsei University, Seoul, Korea.

Correspondence: Seong-Ho Choi. Department of Periodontology, College of Dentistry, Yonsei University, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. shchoi726@yuhc.ac, Tel: 02-2228-3189, Fax: 02-392-0398

Received 3 February 2009 Accepted 6 March 2009

Abstract

Purpose

Bisphophonates are drugs used to suppress osteoclastic activity and to treat osteoporosis, Paget's disease of bone and bone metastasis. The purpose of this report is to review the literatures on bisphopsphonates use that could affect bone healing and cause osteonecrosis of the jaws.

Materials and methods

Medline research was carried out to find relevant articles on bisphophonates and osteonecrosis of the jaw.

Results

Oral administration of bisphopsphonates is reported to decrease the risk of adverse bone outcomes. On the contrary, IV bisphopsphonates is known to significantly increase the risk. Prevention of the osteonecrosis of the jaw is primary concern before usage. If the adverse bone reaction takes place, proper management and treatments are required to alleviate pain of patients and prevent further progression of necrosis.

Conclusion

Case reports of bisphosphonates induced osteonecrosis of the jaw are increasing. Dentists and physicians should be aware of the higher frequency of osteonecrosis of the jaw in patients receiving IV bisphopsphonates and be prepared to prevent and cope with adverse bone reaction.

Keywords: Bisphosphonates, osteonecrosis of the jaw, osteoporosis

Figures and Tables

Figure 1

Chemical formula of basic bisphosphonates structure.

Figure 2

Chemical formula of nitrogen-containing bisphosphonates

Table 1

Current Commercially Available Bisphosphonates

Table 2

Staging of BIONJ and Recommended Treatment Plans

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