[Extensive osteonecrosis of the jaws associated with biphophonates therapy]. / Ostéonécrose extensive des maxillaires induite par les biphosphonates.

ABSTRACT

OBJECTIVE: The purpose of this study was to present the risk of occurrence of osteonecrosis of the jaws during bisphosphonate therapy and to evaluate their involvement. MATERIAL AND METHODS: We report our experience from 2004 to 2005 in the management of three cases of osteonecrosis of the jaws occurring in patients cured by bisphosphonates for metastatic bone disease. Dental extractions preceded the appearance of symptoms for two of the three cases. RESULTS: Bisphosphonates, which inhibit osteoclasts, reduce a great number of the devastating consequences of the metastatic bone disease. Cases of osteonecrosis of the jaw (ONJ) have been reported with a significant increase over the past few years. Bisphosphonates have been used for several decades to reduce the effects of bone metastasis and osteoporosis. However, they seem to play a part in the appearance of the osteonecrosis of the jaws. We studied the pharmacological features of the bisphosphonates and the role they can play in the physiopathology of osteonecrosis. CONCLUSION: Osteonecrosis of the jaws is an uncommon complication of bisphosphonate treatment. Dental care is recommended for every high-risk patient before the beginning bisphosphonate treatment, although total prophylaxis is impossible.