Abstract
ABSTRACTAlthough uncommon in patients under oral therapy, bisphosphonate-related osteonecrosis of the jaw (BRONJ) can be a very severe issue. Early intervention with surgical resection should be the preferable method of treating any stage of the disease, resulting in better outcomes and decreasing the morbidity of this condition. A 77-year-old female patient attended the Special Care Dentistry Centre of the University of São Paulo Faculty of Dentistry (CAPE FOUSP) complaining mainly of “an exposed bone that appeared after tooth extraction performed six months earlier”. The patient was diagnosed with osteonecrosis associated with bisphosphonate (sodium ibandronate) and surgically treated with removal of bone sequestration and antibiotic therapy. The patient was followed up for six years (a total of 6 appointments), presenting good general health and no sign of bone exposure. Imaging findings showed no changes related to BRONJ either.
Highlights
Osteoporosis is a bone metabolic disorder (BMD) characterized by loss of bone mineral density
BPs can be classified depending on their action pattern, that is, nitrogenated or non-nitrogenated, with nitrogen-containing BPs being mostly used because they are more potent 1. Their absorption depends on the gender, age and bone resorption rate of the patient at the time, in addition to the administration route, since absorption of BPs is less than 1% when orally administered compared to the endogenous route, which can reach 50%
Several risk factors are associated with the development of bisphosphonate-related osteonecrosis
Summary
Osteoporosis is a bone metabolic disorder (BMD) characterized by loss of bone mineral density. Its treatment aims to prevent fractures by means of administration of medications, such as bisphosphonates (BPs).[1] Their absorption depends on the gender, age and bone resorption rate of the patient at the time, in addition to the administration route, since absorption of BPs is less than 1% when orally administered compared to the endogenous route, which can reach 50%.2,3
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