Antiresorptive substances and osteonecrosis of the jaws from point of view of stomatology

Abstract

Significant group of antiresorptive substances are bisphosphonates (abbr. BP). They inhibit diferentiation and maturation of osteoclasts, decrease bone resorption. Main indications of the BP are multiple myeloma, Paget´s disease, bone metastases by cancer of prostata, breast cancer, kidney malignancies etc. and by osteoporosis. As negative effect of the BP reveals development of jaw osteonecrosis in some cases, by the American Association for Oromaxilofacial Surgery named BRONJ – bisphosponate related osteonecrosis of the jaws or MRONJ – medication related osteonecrosis of the jaws respectively. Incidence of the osteonecrosis by oral use of the BP is above 1 percent or less, by intravenous application ranges from 1 to 10 percents. Therapy of the developed BRONJ/MRONJ is complicated and long lasting. Therefore the prevention is prefered by sanation of teeth and the oral cavity before start of the BP treatment. Close cooperation is required within the general physician who prescribes the antiresorptive substances and the dentist. Very positive is when the annoucement of the need of consultation with the dentist of the patient is made by the pharmacist. © 2017, Solen s.r.o. All rights reserved.