Document Detail

Effect of long-term oral bisphosphonates on implant wound healing: literature review and a case report.
MedLine Citation:
PMID:  17335384     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Bisphosphonates suppress osteoclast activity, and their intravenous use has been reported in hundreds of cases to be associated with osteonecrosis in the jaw. Little is known of the risks associated with long-term use of oral bisphosphonates despite their use for >10 years by an oral mode of delivery for the treatment of osteopenia, osteoporosis, and Paget's disease of bone. The purpose of this report is to review the literature associated with bisphosphonate use that could impact bone healing and to report a case of bone necrosis in a patient on long-term oral bisphosphonates. METHODS: A Medline search was carried out to find relevant articles from both medical and dental literature between 1960 and 2006. A patient, who had been taking an oral bisphosphonate for >10 years, developed unexplained clinical signs of bone necrosis after routine dental implant placement. This case was followed, documented, and the treatment of the osteonecrosis described. RESULTS: A summary of how bisphosphonates may play a role in wound healing is presented. The compromised healing noted in a patient, who was under long-term oral bisphosphonate use, was successfully treated with systemic antibiotics, local microbial mouthrinse, and aggressive defect management (detoxification and mixture of bone graft and tetracycline). CONCLUSIONS: This case suggests that patients under long-term oral bisphosphonate use should be treated with caution. Well-controlled, prospective clinical trials on the effect of oral bisphosphonates on bone are warranted to determine which patients may be at risk for such complications.
Hom-Lay Wang; Daniel Weber; Laurie K McCauley
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of periodontology     Volume:  78     ISSN:  0022-3492     ISO Abbreviation:  J. Periodontol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-05     Completed Date:  2007-04-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8000345     Medline TA:  J Periodontol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  584-94     Citation Subset:  D; IM    
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
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MeSH Terms
Administration, Oral
Alendronate / administration & dosage,  adverse effects
Anti-Bacterial Agents / therapeutic use
Bone Density Conservation Agents / administration & dosage,  adverse effects*
Bone Regeneration / drug effects*
Bone Transplantation
Dental Implantation, Endosseous / contraindications*
Dental Implants / contraindications*
Diphosphonates / administration & dosage,  adverse effects*
Jaw Diseases / chemically induced*,  therapy
Mouthwashes / therapeutic use
Osteoradionecrosis / chemically induced*,  therapy
Teriparatide / administration & dosage
Wound Healing / drug effects
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Bone Density Conservation Agents; 0/Dental Implants; 0/Diphosphonates; 0/Mouthwashes; 52232-67-4/Teriparatide; 66376-36-1/Alendronate
Comment In:
J Periodontol. 2007 Mar;78(3):373-6   [PMID:  17335360 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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