Bisphosphonates
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Osteonecrosis: case report A 61-year-old woman developed osteonecrosis associated with bisphosphonate therapy for osteoporosis. The woman, who was receiving bisphosphonate therapy [drug, dosage and duration of treatment not stated] and had undergone extraction of four mandibular incisors and socket grafting by a periodontist, was referred with an acute submental space abscess; intraorally, she had an anteriorly denuded mandibular alveolus and symphasis from canine to canine. The woman was hospitalised and her abscess was drained. She received IV antibacterials and hyperbaric oxygen therapy and an arteriogram was performed. Over an 18-month period, she received conservative treatment with weekly periodontal packings and chlorhexidine mouthwash. Bisphosphonate therapy was then discontinued. Within 3 weeks, an increase in granulation and epithelial coverage had started. She developed a complete mucosal coverage of the denuded mandible over the ensuing several months. [Patient outcome not stated.] Author comment: "[T]here appeared to be a direct link with the cessation of the bisphosphonate therapy and the beginning of granulation and epithialization." Herrod NW. Bisphosphomate-associated osteonecrosis. Journal of the American 801040582 Dental Association 137: 439, No. 4, Apr 2006 - USA
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Reactions 22 Jul 2006 No. 1111
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