From Volume 38, Issue 10, December 2011 | Pages 672-678
Bisphosphonates are effective drugs used to treat important medical conditions affecting the skeleton, such as malignancy and osteoporosis. Bisphosphonate-associated osteonecrosis of the jaw (BONJ) is a rare but painful condition that can affect quality of life. Healthcare professionals need to be aware of this potential side-effect of bisphosphonates, as well as ways to minimize its occurrence.
The bisphosphonate group of drugs are pyrophosphate analogues. They have a high affinity to bone and are taken up by osteoclasts during natural bone resorption. Bisphosphonates work by acting on osteoclast function to reduce bone resorption.1 They are important in treating many conditions such as osteoporosis, osteogenesis imperfecta, Paget's disease, skeletal events associated with metastatic cancer, hypercalcaemia, primary hyperparathyroidism and bone cancers such as Ewings Sarcoma (second most common bone cancer in young adolescents). As more research has been performed on bisphosphonates, their applications for use have increased. Consequently, general dental practitioners, dental hygienists and other healthcare workers may come across an increasing number of patients prescribed these drugs. Since bisphosphonates have been associated with osteonecrosis of the jaw (BONJ), it is essential that the management of patients on bisphosphonates is understood, the higher risk patient groups are identified and the risk of BONJ is minimized.
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