Osteonecrosis of the Jaw Related to Oral Bisphosphonate Treatment: A Clinical Case.
Bisphosphonates are inhibitors of osteoclastic activity and hence cause inhibition of
bone resorption. These drugs, which are synthetic analogy of natural pyrophosphate,
have proven their effectiveness in the treatment of diverse metabolic bone diseases related to quantitative alterations, as is the case of osteoporosis, or qualitative ones, as in Paget’s disease.7
The most common way for their administration is orally.
These anti-resorptive drugs cause an increase of bone mineral density
and a quick decrease of fracture risk.
They are also effective in oncology patients. Additionally, these medicines
reduce the symptoms of bone pathology. They are normally administered intravenously.
Bisphosphonates have anti-cancer effect alone or in combination
with other chemotherapy treatments, as they maximize antineoplastic effects.
In pediatrics, they are used in the treatment of diseases related
to abnormal calcinosis or ectopic bone formation, as is the case of osteogenesis imperfect.
Based on a total of 36 cases, Marx, et al. reported an adverse effect of the use of these
drugs, which is called Osteonecrosis of the Jaw. Ruggiero, further reported that of
a total of 63 cases of patients with ONJ, 11.1% suffered originally from osteoporosis.
Since then, numerous medical entities, scientific associations and expert committees
have researched this adverse effect. It is known that it can appear spontaneously, with an
estimated prevalence of 50% in the case of intravenously administered bisphosphonates and
30% in the case of oral administration.
There are factors inherent to the drug that can increase the risk of ONJ, such as bisphosphonate
type, potency, or length of treatment. Usage of corticoids can also augment the risk of suffering from this complication.
Dent Open J. 2014; 1(1): 19- 24. doi: 10.17140/DOJ-1-105