Bisphosphonate-related jaw necrosis – Severe complication in Maxillofacial surgery

Summary Bisphosphonates are used as potent inhibitors in metastatic bone lesions. They can reduce skeletal burden and prevent bony metastases. They are integral in the treatment of some tumours like breast cancer, prostate cancer and multiple myeloma. As a side effect, these drugs also may cause sev...

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Bibliographic Details
Published in:Cancer treatment reviews 2007-02, Vol.33 (1), p.58-63
Main Authors: Eckert, A.W, Maurer, P, Meyer, L, Kriwalsky, M.S, Rohrberg, R, Schneider, D, Bilkenroth, U, Schubert, J
Format: Article
Language:English
Subjects:
Avascular jaw necrosis
Bisphosphonates
Bone metastasis
Bone Neoplasms - drug therapy
Bone Neoplasms - secondary
Diphosphonates - adverse effects
Hematology, Oncology and Palliative Medicine
Humans
Jaw - pathology
Necrosis - chemically induced
Necrosis - prevention & control
Necrosis - surgery
Recurrence
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Summary:Summary Bisphosphonates are used as potent inhibitors in metastatic bone lesions. They can reduce skeletal burden and prevent bony metastases. They are integral in the treatment of some tumours like breast cancer, prostate cancer and multiple myeloma. As a side effect, these drugs also may cause severe jaw necrosis. Twenty-four patients with bisphosphonate-related jaw necrosis were analyzed in a clinical study. These necroses mostly appeared after administration of aminobisphosphonates. Recurrent avascular necroses were found after changing from Pramidronate to Zoledronate. All patients were treated by resection of necrotic bone. Repeated surgical interventions were required with about 25% of the patients. The management of patients with bisphosphonate-related jaw necrosis remains extremely difficult and includes surgical procedures as well as the eradicating of the necrotic bone including antibiotic therapy. The prevention of such complications consists in a minimization of dental surgical interventions and an avoidance of ulcers by dental prosthesis.
ISSN:0305-7372
1532-1967
DOI:10.1016/j.ctrv.2006.09.003