Abstract

JOSHI OTERO, J. et al. Bisphosphonate-related jaw osteonecrosis: Review of eight cases. Rev Esp Cirug Oral y Maxilofac [online]. 2011, vol.33, n.1, pp.15-21. ISSN 2173-9161.

Background: In late 2003, an increasing number of case reports began to appear on bone exposure of the jaw with a torpid evolution in association with intravenous bisphosphonate use. Bisphosphonates are used to inhibit bone resorption in patients with osteoporosis, multiple myeloma, hypercalcemia of malignancy, lung cancer, breast cancer and prostate cancer. Material and methods: A prospective study was made of patients from Hospital Virgen Macarena who presented bisphosphonate associated jaw lesions from 2006 to the present. The patient variables examined were: sex, age, bisphosphonate treatment, onset of osteonecrosis and its relation to dental treatment, treatment, and outcome. Results: Eight patients with osteonecrosis of the jaw secondary to treatment with intravenous or oral bisphosphonates for oncologic or osteoporotic pathology were treated according to their clinical and radiological findings with antibiotics and curettage and/or excision of sequestered bone, as needed. Results with a minimum follow up of 15 months are reported. Conclusions: The increased incidence of maxillary osteomyelitis in patients treated with bisphosphonates and the difficulty of treatment make it necessary to establish standard therapeutic guidelines. In the authors' experience, conservative treatment based on antibiotic therapy and/or curettage of the area under local anesthesia can adequately control and resolve the process in some patients with stage II BRJO.

Keywords : Osteonecrosis; Bisphosphonates; Jaw; Bisphosphonate-related jaw osteonecrosis (BRJO); Osteomyelitis; Cancer.

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