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Review
. 2015 Dec 6;46(5):495-9.
doi: 10.1016/S2255-4971(15)30402-X. eCollection 2011 Sep-Oct.

BISPHOSPHONATE-INDUCED MAXILLOFACIAL OSTEONECROSIS IN OSTEOPOROTIC INDIVIDUALS

Paulo Sérgio da Silva Santos  1 , Márcio Augusto Oliveira  2 , Valtuir Barbosa Felix  3
Affiliations
Review

BISPHOSPHONATE-INDUCED MAXILLOFACIAL OSTEONECROSIS IN OSTEOPOROTIC INDIVIDUALS

Paulo Sérgio da Silva Santos et al. Rev Bras Ortop. .

Abstract

Bisphosphonate-related osteonecrosis of the maxillae may be an important complication of long-term osteoporosis treatment. The possibility of osteonecrosis of the maxillae in patients exposed to nitrogenated bisphosphonates was first described in 2003. Since then, case reports and retrospective studies have demonstrated higher percentages of occurrence of osteonecrosis in patients who have used or are using bisphosphonates. Although this complication may be spontaneous, invasive oral procedures have a role as risk factors associated with dental procedures such as tooth extractions and other bone operations. In addition, tooth infections and periodontal disease have been reported to be the main risk factors for development of bisphosphonate-induced osteonecrosis of the maxillae. For this reason, dentists, general clinicians, orthopedists, geriatricians and oral-maxillofacial surgeons need to be aware of this problem and work in a multidisciplinary environment, thereby stimulating early diagnosis and prevention of further potential cases.

Keywords: Bisphosphonates; Facial Bones; Osteoporosis.

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Figures

Figure 1
Figure 1
Panoramic radiograph showing extensive involvement of the mandible, with bone lesion in the right posterior portion.
Figure 2
Figure 2
Surgical specimen from mandible showing extensive ONB with pathological fracture.
Figure 3
Figure 3
Computed tomography image showing extensive mandibular bone destruction.
See this image and copyright information in PMC

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