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Sammanfattning

Bisphosphonates are drugs used to treat malignant bone metastases and osteoporosis. Exposed and necrotic bone, with a predilection for the jaws, is a recently described adverse side effect of such therapy. Bisphosphonate-associated osteonecrosis of the jaw appears to result from a complex interaction of suppressed osteoclast function, local trauma, infection, hypovascularity and increased demand for bone repair. The prevalence of osteonecrosis is about 6?-?10??% in patients with cancer receiving intravenous treatment. The prevalence appears to be significantly lower in patients receiving bisphosphonates for osteoporosis. A matter of concern is that the cumulative accumulation in bone during long-term therapy increases the risk. The Norwegian Medicines Agency have received 27 reports of bisphosphonate-associated jaw necrosis, two in 2004, five in 2005 and 20 in 2006 (two of these used alendronate for osteoporosis. This paper comments on a third case with alendronate. Yearly 100?-?200 patients in Norway receive bisphosphonate therapy for malignancy, whereas about 56 000 use bisphosphonates for osteoporosis. Physicians and dentists with special qualifications should take care of the relatively few patients with malignancy. There is also a need for close attention to the dental health of the large group of patients receiving bisphosphonates for osteoporosis. The main aim of this paper is to provide information to general dentists in Norway about osteoporosis and preventive measures to reduce the risk of obtaining bisphosphonate-associated jaw necrosis.

MeSH