passage-158
abstract
Bisphosphonate-induced necrosis of the jaws: a reconstructive nightmare.  PURPOSE OF REVIEW: Bisphosphonates are used for the management of metastatic bone disease, prevention and treatment of osteoporosis and Paget's disease of bone. An increasing number of reports have associated the use of bisphosphonates with the occurrence of osteoradionecrosis of the jaw. The purpose of this review is to summarize the recent literature in this area, specifically focusing on its management. RECENT FINDINGS: Osteoradionecrosis of the jaw mostly results from the use of intravenous bisphosphonates for metastatic bone disease and multiple myeloma; cases from oral treatment for osteoporosis and Paget's disease have also been reported. It mostly affects the posterior maxilla, followed by the posterior mandible. In more than half of the affected patients, there has been preceding dental trauma or procedure. Many treatment modalities have been attempted in order to limit disease progression. Conservative management with antibiotic therapy and mouthwashes seems to be most beneficial. Surgery should be reserved for refractory and symptomatic cases. SUMMARY: It is important for the reconstructive head and neck surgeon to recognize the clinical presentation of bisphosphonate-induced osteoradionecrosis of the jaw and the role of conservative management in consistently achieving good results.
entity-158-0
ADVERSE
necrosis of the jaws
entity-158-1
DISEASE
metastatic bone disease
entity-158-2
DISEASE
osteoporosis
entity-158-3
DISEASE
Paget's disease
entity-158-4
ADVERSE
osteoradionecrosis of the jaw
entity-158-5
ADVERSE
Osteoradionecrosis of the jaw
entity-158-6
DISEASE
metastatic bone disease
entity-158-7
DISEASE
multiple myeloma
entity-158-8
DISEASE
osteoporosis
entity-158-9
DISEASE
Paget's disease
entity-158-10
DISEASE
dental trauma
entity-158-11
ADVERSE
osteoradionecrosis of the jaw