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      Cuando la osteonecrosis por bisfosfonatos acecha. Reporte de un caso Translated title: When bisphosphonate osteonecrosis lurks. Report of a case

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          Abstract

          RESUMEN El envejecimiento progresivo de la población española puede incrementar el riesgo de padecer diversas patologías óseas como la osteoporosis, que junto con distintos procesos oncológicos suelen conllevar el consumo de fármacos como los bisfosfonatos. La toma de este tipo de medicamentos puede ocasionar efectos secundarios, como la osteonecrosis de los maxilares. Se presenta un caso clínico atendido en el Servicio de Prácticas Odontológicas de la Universidad de Zaragoza, donde tras la toma de bisfosfonatos apareció osteonecrosis mandibular. El abordaje de estos pacientes se realiza desde un punto de vista multidisciplinar, por lo que el manejo clínico fue realizado en coordinación con el Servicio de Cirugía Oral y Maxilofacial del Hospital Universitario Miguel Servet de Zaragoza.

          Translated abstract

          ABSTRACT The progressive aging of the Spanish population may increase the risk of suffering from various bone pathologies such as osteoporosis, which together with different oncological processes usually lead to the consumption of drugs such as bisphosphonates. Taking these types of drugs can cause side effects, such as osteonecrosis of the jaws. A clinical case treated in the Dental Practice Service of the University of Saragossa is presented, where after taking bisphosphonates, osteonecrosis of the jaw appeared. These patients are approached from a multidisciplinary point of view, so the clinical management was carried out in coordination with the Oral and Maxillofacial Surgery Service of the Miguel Servet University Hospital in Saragossa.

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          American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update.

          Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaw (MRONJ) were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007 and 2009. The position papers were developed by a special committee appointed by the board and composed of clinicians with extensive experience in caring for these patients and basic science researchers. The knowledge base and experience in addressing MRONJ has expanded, necessitating modifications and refinements to the previous position paper. This special committee met in September 2013 to appraise the current literature and revise the guidelines as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis, staging, and management strategies and highlights current research status. The AAOMS considers it vitally important that this information be disseminated to other relevant health care professionals and organizations.
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            Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs.

            This narrative review of osteonecrosis of the jaw in patients with low bone mass receiving treatment with antiresorptive agents is based on an appraisal of the literature by an advisory committee of the American Dental Association Council on Scientific Affairs. It updates the committee's 2008 advisory statement. The authors searched MEDLINE for literature published between May 2008 (the end date of the last search) and February 2011. This report contains recommendations based on the findings of the literature search and on expert opinion that relate to general dentistry; periodontal disease management; implant placement and maintenance; oral and maxillofacial surgery; endodontics; restorative dentistry and prosthodontics; orthodontics; and C-terminal telopeptide testing and drug holidays. The highest reliable estimate of antiresorptive agent-induced osteonecrosis of the jaw (ARONJ) prevalence is approximately 0.10 percent. Osteoporosis is responsible for considerable morbidity and mortality. Therefore, the benefit provided by antiresorptive therapy outweighs the low risk of developing osteonecrosis of the jaw. An oral health program consisting of sound hygiene practices and regular dental care may be the optimal approach for lowering ARONJ risk. No validated diagnostic technique exists to determine which patients are at increased risk of developing ARONJ. Discontinuing bisphosphonate therapy may not lower the risk but may have a negative effect on low-bone-mass-treatment outcomes.
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              Stage-specific therapeutic strategies of medication-related osteonecrosis of the jaws: a systematic review and meta-analysis of the drug suspension protocol.

              The most debated topic about medication-related osteonecrosis of the jaws (MRONJ) is its therapy, as there are no definitive guidelines. The aims of this systematic review were (a) to outline the best therapeutic approach according to the stage at diagnosis and (b) to perform a meta-analysis to assess whether the drug-holiday protocol may be or not an effective method in the management of MRONJ patients.
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                Author and article information

                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                June 2022
                : 38
                : 2
                : 60-63
                Affiliations
                [3] Huesca Aragón orgnameUniversidad de Zaragoza orgdiv1Facultad de Ciencias de la Salud y del Deporte Spain
                [4] Zaragoza orgnameHospital Universitario Miguel Servet orgdiv1Servicio de Cirugía Oral y Maxilofacial España
                [2] Huesca Aragón orgnameUniversidad de Zaragoza orgdiv1Facultad de Ciencias de la Salud y del Deporte Spain
                [1] Huesca Aragón orgnameUniversidad de Zaragoza orgdiv1Facultad de Ciencias de la Salud y del Deporte Spain
                Article
                S0213-12852022000200003 S0213-1285(22)03800200003
                eb73931a-a86f-4c48-8546-6cdda124d034

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 07 February 2021
                : 04 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Spain

                Categories
                Artículos

                osteonecrosis mandibular,bisphosphonates,osteoporosis,jaw osteonecrosis,bisfosfonatos

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