Osteonecrosis of the jaw in association to bisphosphonates
Mattos, Ana Carolina Lopes
MetadataShow full item record
The use of bisphosphonate has become more widespread for the treatment of bone metastasis, multiple myeloma, osteoporosis, Paget's disease and other bone malignancies. Osteonecrosis of the jaw (ONJ) has been recently recognized as a possible complication of the use of bisphosphonate therapy. This study includes a review of the literature on the mechanism of action of bisphosphonate and its potential association to the development of osteonecrosis of the jaw. The inhibitory effects of bisphosphonates on osteoclasts and its antiangiogenic properties have been examined as possible mechanisms to induce osteonecrosis of the jaw. The incidence of ONJ in osteoporosis patients receiving bisphosphonate treatment is <1 in 100,000, and in between 1% and 10% in patients with malignancy (Hess et al., 2008). The results of this study suggest a higher incidence of osteonecrosis of the jaw in patients under long term use of nitrogen containing bisphosphonate. The incidence of bisphosphonate associated ONJ in the first 4 to 12 months of therapy was of 1.5% and it increased to 7.7% after 37 to 48 months [Bamias] Additional risk factors include dental extractions, invasive dental procedures and trauma. It is not yet clear, however, if other drugs that affect bone turnover may induce similar complications. This study suggests an association of bisphosphonates to the development of osteonecrosis of the jaw. There is no evidence that bisphosphonates cause osteonecrosis of the jaw. An evaluation of the published data indicates that more research is necessary to understand the relationship of bisphosphonates and osteonecrosis of the jaw.
Thesis (M.A.)--Boston University, 2008.
RightsThis work is being made available in OpenBU by permission of its author, and is available for research purposes only. All rights are reserved to the author.