Osteoporosis and bisphosphonate-related osteonecrosis of the jaw bone.

The aim of this longitudinal study is to present data from 76 female patients treated with bisphosphonates (BPs) for postmenopausal osteoporosis and referred to the Unit of Oral Diagnosis and Day Surgery of the University of Milano for diagnosis and treatment. All patients received a thorough oral examination. The diagnosis of osteonecrosis of the jaw bone (ONJ) was made from radiographic and clinical findings. 9% of individuals had BRONJ at first visit. Patients with dental or periodontal abscess were significantly more likely to develop BRONJ (OR: 2.9, 95% CI 0.5-15.9). Patients with osteoporosis receiving BPs may develop BRONJ, especially in the presence of an active infectious process in the mouth. Clinicians should carefully follow up on individuals receiving bisphosphonates therapy to avoid the occurrence of osteonecrotic lesions.

Oral surgery in patients on anticoagulant treatment without therapy interruption.

PURPOSE: Conflicting opinions exist in literature concerning the management of oral surgery in patients on oral anticoagulants because no consensus on perioperative protocols is available, including precise guidelines regarding the need for therapy modification or withdrawal. The aim of this study was to evaluate bleeding complications associated with oral surgery performed on patients on oral anticoagulants without therapy modification or withdrawal but following a standardized comprehensive perioperative management protocol. PATIENTS AND METHODS: Patients on oral anticoagulant therapy with warfarin and in need of oral surgery underwent a thorough general and oral clinical evaluation to assess thromboembolic and bleeding risk; 255 subjects who, on the morning of surgery, had INR values