Management of bisphosphonate preparation-treated children in the field of pediatric dentistry

Abstract

Since most of the reports of BRONJ onset are adults, in order to clarify the current situation of BRONJ onset in children, it is necessary to search for articles and report on the current status and actual conditions of surgical treatment of children with BP preparations who are being followed up in our clinic. In previous reports both inside and outside Japan, there was no mention of jaw bone necrosis during tooth extraction or surgery in children who were receiving or had a history of BP administration. There were 15 children with a history of BP administration who manage the oral cavity in our clinic. No unpleasant events in the extraction of deciduous teeth were confirmed in medical records. It is necessary to intervene early on oral management of pediatric BP-administered children, especially BP-and steroid-administered children, obtain plaque control to keep the oral cavity cleaner, respond early to infectious diseases, and manage to prevent inflammation from spreading to the jawbone. When surgical treatment is unavoidable, it is important to consider reducing the invasion as much as possible and to cooperate with the medical department such as administration of antibiotics to prevent infection.

Keywords: BRONJ; Bisphosphonate; Children; Osteogenesis imperfecta; Osteoporosis; Tooth extraction.

Fig. 1

An intraoral photograph and X-ray at the first visit out clinic (14 years and 3 months). It is indicated lower left first molar dentin caries, upper left second primary molar prolonged retention, upper left second premolar malposition and impaction and lower right third molar and second molar follicular dental cyst.

Fig. 2

Secular change of the extraction area (Panoramic X-ray photograph).

Fig. 3

Dental X-ray photograph and the intraoral photograph. A dental X-ray and intraoral photogarph of lower right second molar equivalency area. B intraoral photograph (22 year and 6 moths old).