The Pharmaceutical Influence, Clinical Analysis, and Managerial Treatment of Bisphosphonates-associated Osteonecrosis
Murphy, M. Timothy
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Incidence of skeletal diseases has increased concomitantly with other degenerative diseases. In response, pharmaceutical companies have begun using bisphosphonates, which were originally employed in the industrial sector over a century (Licata, 2005). However, since bisphosphonates also have a strong affinity to hydroxyapatite, they are useful in the medical field (Tech Rpt of Zometa®, 2005). Yet, post-market research has uncovered adverse effects associated with bisphosphonate therapy. These side-effects are only associated with the nitrogen-based bisphosphonate derivatives and are part of a larger disorder called bisphosphonate-associated osteonecrosis (BON). The complications associated with BON include oral lesions, non-healing gingival wounds, and osteonecrosis of the jaw, yet these side-effects are only observed in 0.7 out of everyone 1 00,000 patients undergoing bisphosphonate therapy (ADASCA, 2006). Treatment options for symptoms of BON are very limited, because of its rarity and infrequency. Beside sequestrectomies, no treatments have been successful after BON fully develops. Therefore, a preventive treatment plan is the most effective measure in the fight against BON. The preventive care hinges on cooperation between both dentists and physicians. Without proper communication between clinicians, the probability of developing BON increases. To decrease the chance of developing BON, patient's cancer treatments and osteoporosis therapies should be approved by both practitioners. This protocol will reduce the amount of future oral trauma, which is one of the steps of the pathobiological development of BON.