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In 2003, [9] [10] reports surfaced of the increased risk of osteonecrosis in patients receiving these therapies concomitant with intravenous bisphosphonate. [11] Matrix metalloproteinase-2 may be a candidate gene for bisphosphonate-associated osteonecrosis of the jaws, since it is the only gene known to be associated with both bone ...
The degree of risk for osteonecrosis in patients taking oral bisphosphonates, such as alendronate (Fosamax), for osteoporosis is uncertain and warrants careful monitoring. [21] Patients taking dexamethasone and other glucocorticoids are at increased risk. [22]
With the advent of implant dentistry, more dental patients are undergoing therapies in the oral cavity that involve bone healing, such as surgical implant placement and bone grafting procedures. In order to evaluate the risk of osteonecrosis for a patient taking bisphosphonates, use of the CTX biomarker was introduced in 2000 by Rosen. [2]
Other risk factors include radiation therapy, chemotherapy, and organ transplantation. [1] Osteonecrosis is also associated with cancer, lupus, sickle cell disease, [11] HIV infection, Gaucher's disease, and Caisson disease (dysbaric osteonecrosis). [1] [12] Bisphosphonates are associated with osteonecrosis of the mandible (jawbone). [13]
The current, more correct, term, osteomyelitis of the jaws, differentiates the condition from the relatively recent and better known phenomenon of bisphosphonate-caused osteonecrosis of the jaws. The latter is found primarily in post-menopausal women given bisphosphonate medications, usually against osteoporosis.
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Similarly to bisphosphonates, denosumab appears to be implicated in increasing the risk of osteonecrosis of the jaw (ONJ) following extraction of teeth or oral surgical procedures but, unlike bisphosphonate, the risk declines to zero approximately 6 months after injection. [23] Invasive dental procedures should be avoided during this time.
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