Oral Bisphosphonates And Relationship To ONJ And Dental Implants

Pouran Famili

doi:10.4172/2161-1122.1000188

Abstract

Osteoporosis is a multifactorial, systemic skeletal disease generally affecting older females. It reduces bone mineral density and decreases bone strength, resulting in increased bone fragility and risk of bone fracture(s). Dental implants meanwhile are increasingly sought out by this population. It is clinically necessary to understand the effect of implant success on patients with skeletal low bone mineral density who is also receiving treatment for osteoporosis with oral bisphosphonates. In our ongoing research regarding once-yearly IV bisphosphonate zoledronic acid to prevent osteoporosis in elderly nursing home patients, to date 252 patients have been followed one year after treatment. No osteonecrosis of the jaw has been observed. Collaborative ongoing research by this author has shown dental implants can survive regardless of osteoporosis and even taking bisphosphonates for treatment of osteoporosis. Follow-up for two years on twenty patients has shown no failing implants.

Highlights

Osteoporosis is a multifactorial, systemic skeletal disease generally affecting older females
Wang et al [1] reported the first case of osteonecrosis of the jaw (ONJ) associated with bisphosphonate therapy in cancer patients
Initial reports showed that ONJ was mainly associated with metastatic breast cancer and multiple myeloma [3] and it was clear that patients taking higher cumulative doses of bisphosphonates had greater risk of developing ONJ

Summary

Introduction

Osteoporosis is a multifactorial, systemic skeletal disease generally affecting older females. Bisphosphonates were introduced in the mid-1990s as an alternative to hormone replacement therapies for treatment of osteoporosis. In 1996 Fosamax® (alendronate, marketed by Merck) was the first bisphosphonate drug approved in the U.S for the treatment of osteoporosis. Bisphosphonates bind and accumulate in bone and remain there for months after therapy is discontinued.

Results

Conclusion