Metabolic relationships of bisphosphonate-induced osteonecrosis of the jaw: review

Abstract

Bifosphonates are antiresorptive drugs of choice in the treatment of a wide range of osteolytic pathologies, such as osteoporosis, Piaget’s disease, hypercalcemia associated with bone metastasis and bone lesions due to multiple myeloma, among others (Adober et ál., 2000). The orally use of these drugs reports adverse effects in the digestive tract: nausea, abdominal pain, heartburn, ulcers and esophageal stenosis (Jódar et ál., 2002). Since 2003, they have also been associated with a bone exposure in the maxilla called bisphosphonate-induced osteonecrosis of jaws; particularly in intravenous application with greater bioavailability (Marx et ál., 2003).

In patients who consume BFs aggressive dental treatments can trigger osteonecrosis of the jaw (Barquero, 2016). The present review focuses on mechanisms of action of BFs that justify their therapeutic action and adverse effects, among them the development of osteonecrosis of jaw; also seeks to It also aims to draw attention to the need to establish dental protocols for patients who are treated with BFs for long periods.