Jaw osteonecrosis associated with the use of bisphosphonates: literature review

Abstract

Osteonecrosis of the jaws is a complication associated with the prolonged use of bisphosphonate drugs, denosumab (antiresorptive) and the use of the antiangiogenic drug bevacizumab. These are used for metabolic and oncological diseases, in order to decrease the resorptive action of osteoclasts and induce deposition by osteoblasts. The objective is through a literature review to raise the consequences of the use of bisphosphonates in the oral cavity and the importance of prevention and treatment of patients who use this medication. The time of use of the medication, or the potency of it, may result in the formation of an excessively hard bone. When the use of bisphosphonates is intravenous, it predisposes to osteonecrosis. The patient using these drugs, when submitted to more invasive dental procedures, such as dental alveoli extractions, increases the likelihood of developing the disease. Therefore, it is concluded that the best conduct when necessary to use bisphosphonates is prevention, performing an adaptation of the oral environment before using the medication and periodically looking for a dental surgeon in order to analyze the oral health situation, reducing the chances of the incidence of bone injuries.