Which bisphosphonate causes osteonecrosis of the jaw?
Which bisphosphonate causes osteonecrosis of the jaw?
The incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been strongly correlated with the aminobisphosphonates pamidronate (Aredia) and zoledronic acid (Zometa) and is even higher in patients who have had recent dental extractions.
What is the risk of osteonecrosis of the jaw with bisphosphonates?
Among cancer patients receiving high-dose intravenous bisphosphonates, osteonecrosis of the jaw is dependent on dose and duration of therapy,17–20 and has an estimated incidence of 1% to 12%.
Why do bisphosphonates cause Mronj?
The risk of a patient having MRONJ after discontinuing this medication is unknown. There are suggestions that bisphosphonate may inhibit the proliferation of soft tissue cells and increases apoptosis. This may result in delayed soft tissue healing.
Which drug is associated with osteonecrosis of the jaws?
Osteonecrosis of the jaw (ONJ) can be caused by two pharmacological agents: Antiresorptive (including bisphosphonates (BPs) and receptor activator of nuclear factor kappa-B ligand [RANK-L] inhibitors) and antiangiogenic.
What causes jaw osteonecrosis?
Osteonecrosis of the jaw can occur after tooth extraction, injury, radiation therapy, or for no apparent reason. Osteonecrosis of the jaw has occurred in some people taking high doses of bisphosphonate drugs intravenously, particularly if they have cancer or undergo oral surgery.
How is osteonecrosis of jaw treated?
Treatments for osteonecrosis of the jaw may include antibiotics, pain relief medication or oral rinses. Minor dental work may be necessary to remove injured tissue and reduce sharp edges of the bone. Surgery is typically avoided because it has not been reliably shown to help.
What is the most common side effect of bisphosphonate?
The most common side effects of bisphosphonates are stomach irritation and heartburn, but these problems are often avoided by taking the medication correctly. Other common side effects include: Bone or joint pain, or generalized pain. Muscle cramps or aches.
How do bisphosphonates cause atypical fractures?
Long-term bisphosphonate therapy can change bones at the microscopic level to make them more susceptible to the rare catastrophic transverse breaks known as atypical femoral fractures (AFFs), scientists said.
Why do bisphosphonates cause fractures?
What happens if you get osteonecrosis of the jaw?
It can cause tooth or jaw pain and swelling in your jaw. Severe symptoms include infection in your jaw bone. You can get ONJ after some dental surgeries, such as getting teeth extracted (removed) or implanted. If this happens, it may take a long time for you to heal after dental surgery or you may not heal at all.
Why is there a higher concentration of bisphosphonates in the jaw?
Bisphosphonates bind to osteoclasts and accumulate at sites of high bone turnover. Hence, there is a higher concentration of bisphosphonates in the jaw. Some theories suggest, and there is some supporting evidence, that the necrosis is caused by the inhibition of bone remodeling secondary to the suppression of bone resorption. 6, 8, 9
When to include ONJ in the differential diagnosis of bisphosphonate therapy?
The radiologist should be aware of ONJ and include it in the differential diagnosis when evaluating patients with a history of bisphosphonate therapy without jaw irradiation, so as to avoid potentially harmful biopsies. After reading this article and taking the test, the reader will be able to: •.
What are bisphosphonates used to treat?
Bisphosphonates are inorganic pyrophosphates that decrease bone turnover and are used to reduce bone pain, improve quality of life, and reduce or delay skeletal complications such as fractures in patients with metastatic lytic lesions, hypercalcemia related to malignancy, multiple myeloma, Paget disease of bone, and osteoporosis.
What is the optimal duration of bisphosphonate treatment for osteoporosis?
The optimal duration of bisphosphonate treatment for osteoporosis is uncertain. In a randomized controlled trial comparing five versus 10 years of alendronate (Fosamax) therapy, there were statistically significant improvements in bone mineral density and a lower risk of clinical vertebral fractures with 10 years of therapy.