Medicus, Vol. 31 No. 2 Osteoporoza, 2022.
Review article
Antiresorptive Treatment in Dentistry
Marko Granić
Abstract
Antiresorptive drugs are used in the treatment of various bone conditions such as osteoporosis, conditions associated with malignant diseases (malignant hypercalcemia, pathological fractures), bone metastases from solid tumors (breast, prostate, lung and kidney), multiple myeloma, and rare bone conditions such as Paget's disease, osteomalacia, etc. Drugs with an antiresorptive effect include bisphosphonates and denosumab, while romosozumab has an antiresorptive and osteoanabolic effect. Hormonal replacement therapy and SERMs are also antiresorptive drugs, but their usage is rare today. SERMs, for example, is currently unavailable in Croatia. All of these drugs have shown a high therapeutic effect on the underlying disease or condition, however, in recent years, there are increasing amounts of side effects of certain drug classes in the oral cavity. Highly potent antiresorptive drugs are proven to accumulate in places of active remodeling, of which the alveolar ridge of the jaw bone is the most exposed. This results in specific sclerosing of the alveolar bone around the tooth, which can cause reduced, difficult or even complete absence of healing after dental procedures in the oral cavity. The most serious complication of the mentioned drugs in the oral cavity is the occurrence of a specific osteonecrosis called “medication-related osteonecrosis of the jaw”. Therapy for osteonecrosis is non-specific, complicated, and with an unpredictable outcome. Treatment and prevention of osteonecrosis is multidisciplinary, and requires the cooperation of different specialists and the patient himself.
Keywords
osteonecrosis of the jaw; medication-related osteonecrosis of the jaw; antiresorptive therapy
Hrčak ID:
291568
URI
Publication date:
17.1.2023.
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