Further research into Bisphossy jaw [BRONJ]


The most common treatment today for osteoporosis is a class of drugs called bisphosphonates. But as a team of researchers has written in the Journal of Oral Implantology, “these drugs can have major complications that affect already weak bones, preventing them from getting blood and thus causing them to die.” Much has been written about the genetic link between bisphosphonates and osteonecrosis of the jaw [BRONJ] – colloquially referred to as “Bisphossy jaw” – including in Bite, but the authors of the article sought to establish whether a patient managing osteoporosis with bisphosphonates is at greater risk of experiencing serious complication of the jawbone.

The team looked at patients over 54 years of age who were receiving dental implants, comparing their success with patients both with and without osteoporosis, following 24 post-menopausal women who had lost the majority of their teeth. Half of these patients had osteoporosis and were taking the bisphosphonate zoledronic acid once a year intravenously; the other half did not have this bone disorder and did not take the drug. Dental surgeons extracted all of the remaining teeth from each of the 24 women and immediately replaced them with dental implants. They examined them one year later to determine whether the implants were working.

The researchers found that the implants were still in place after one year across all patients; despite some bone loss, there appeared no dead bone among the patients who had taken zoledronic acid. The authors found that installing the implants immediately after extracting the remaining teeth reduced the number of surgeries, sped up the overall process, increased patient comfort, and produced good results even in patients with osteoporosis. The authors concluded that by inserting implants soon after removing teeth, it is possible to decrease the risk of BRONJ among patients with osteoporosis. They noted that patients taking such bisphosphonates should avoid elective oral surgery, but if it is essential, it can be successful. They recommend implant surgery immediately after tooth removal, calling it a “safe treatment modality” for patients with osteoporosis.


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