Dental and Medical Problems

Dent Med Probl
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ISSN 1644-387X (print)
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Dental and Medical Problems

2018, vol. 55, nr 4, October-December, p. 425–429

doi: 10.17219/dmp/99021

Publication type: review article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Prophylaxis of osteonecrosis in the case of patients treated with bisphosphonates: A review paper

Zapobieganie martwicy kości u pacjentów leczonych bisfosfonianami – przegląd piśmiennictwa

Paweł Nieckula1,A,B,C,D,E,F, Anna Stempniewicz2,A,B,C,D, Monika Tubaja2,A,B,C,D

1 Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Warsaw, Poland

2 Medical University of Warsaw, Poland


Bisphosphonates are a group of medicines used in the treatment of oncological osteoporosis, Paget disease and osteogenesis imperfecta. They significantly interfere with the regeneration processes of bone tissue and have a tendency to accumulate in the areas of increased bone remodeling, i.e., the maxilla and the mandible. One of their most serious and problematic side effects is the induction of bisphosphonaterelated osteonecrosis of the jaw (BRONJ), characterized by an exposed, necrotic bone in the maxillofacial area, which lasts longer than 8 weeks, in the case of a patient who is using or was using bisphosphonates and who did not undergo radiotherapy in this anatomical area. Dentistry manipulations are one of the factors which may increase the risk of BRONJ occurrence. The existing recommendations for preventing osteonecrosis are ambiguous. Some authors recommend that the bisphosphonate therapy be discontinued prior to dental procedures, while others say that there is no evidence for the effectiveness of interrupting the therapy. There is also no unequivocal attitude toward antibiotic prophylaxis. According to this research, each case should be considered individually, primarily having regard to the good of a patient.

Key words

oral health, bisphosphonates, prophylaxis, bone healing, osteonecrosis

Słowa kluczowe

zdrowie jamy ustnej, bisfosfoniany, profilaktyka, gojenie się kości, martwica kości

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