References

Ruggiero Sl, Dodson TB, Fantasia J American Association of Oral and Maxillo-facial surgeons position paper on medication-related osteonecrosis of the jaw. J Oral Maxillofac Surg. 2014; 72:1938-1956
Patel V, Kelleher M, Sproat C, Kwok J, McGurk M New cancer therapies and jaw necrosis. Br Dent J. 2015; 219:203-207

Relevance of bisphosphonate therapy in osteoporosis and cancer - no cause for alarm in dentistry (dent update 2016; 43: 235–242)

From Volume 43, Issue 6, July 2016 | Pages 588-589

Authors

Martin Kelleher

MSc, FDSRCS, FDSRCPS, FCGDent

Specialist in Restorative Dentistry and Prosthodontics, Consultant in Restorative Dentistry, King's College Dental Hospital

Articles by Martin Kelleher

Email Martin Kelleher

Mark McGurk

MD, FRCS, DLO, FDS, RCS

Consultant, Department of Oral and Maxillofacial Surgery, Guy's, King's and St Thomas' Dental Institute, SE1 9RT, UK

Articles by Mark McGurk

Article

We write to challenge some of the assertions made in this recent paper.

Sadly, the attention grabbing title is rather naïve and/or misleading for general dentists and others. There is cause for concern and possible alarm in dentistry if patients, who have had multiple IV injections of bisphosphonates, usually for cancer, subsequently need to have dental extractions, or other operations involving the bone in their mouth.

While feeling great sympathy for patients who suffer from osteoporosis, the emphasis in the title of this paper and some of the content ought to be challenged, particularly in relation to intravenous bisphosphonates for patients with cancer.

Oral bisphosphonates are reputedly very beneficial in cases of osteoporosis. The risks of Medicine Related OsteoNecrosis of the Jaw (‘MRONJ’) after surgery to the jaws with oral bisphosphonates are so low that they should not be an issue for over 99% of oral surgical interventions. If oral bisphosphonates are taken for very many years and/or if they are combined with other risks, such as a long history of steroids, then the risks of MRONJ following jaw bone surgery are increased, but they are still low.1

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