Bisphosphonate-induced necrosis of the jaws: a reconstructive nightmare.

Abstract:

PURPOSE OF REVIEW:Bisphosphonates are used for the management of metastatic bone disease, prevention and treatment of osteoporosis and Paget's disease of bone. An increasing number of reports have associated the use of bisphosphonates with the occurrence of osteoradionecrosis of the jaw. The purpose of this review is to summarize the recent literature in this area, specifically focusing on its management. RECENT FINDINGS:Osteoradionecrosis of the jaw mostly results from the use of intravenous bisphosphonates for metastatic bone disease and multiple myeloma; cases from oral treatment for osteoporosis and Paget's disease have also been reported. It mostly affects the posterior maxilla, followed by the posterior mandible. In more than half of the affected patients, there has been preceding dental trauma or procedure. Many treatment modalities have been attempted in order to limit disease progression. Conservative management with antibiotic therapy and mouthwashes seems to be most beneficial. Surgery should be reserved for refractory and symptomatic cases. SUMMARY:It is important for the reconstructive head and neck surgeon to recognize the clinical presentation of bisphosphonate-induced osteoradionecrosis of the jaw and the role of conservative management in consistently achieving good results.

authors

Gevorgyan A,Enepekides DJ

doi

10.1097/MOO.0b013e328304b445

subject

Has Abstract

pub_date

2008-08-01 00:00:00

pages

325-30

issue

4

eissn

1068-9508

issn

1531-6998

pii

00020840-200808000-00005

journal_volume

16

pub_type

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