Abstract:

BACKGROUND: Bisphosphonate is a potent osteoclast inhibitor that produces clinical therapeutic effect by inhibiting osteoclast-mediated bone resorption. Bisphosphonate is widely used in the prevention and treatment of osteoporosis, metabolic bone disease, multiple myeloma, hypercalcemia and cancer bone metastases-related bone disease.
OBJECTIVE: To investigate the clinical diagnosis and treatment of bisphosphonate-induced osteonecrosis of the jaws.
METHODS: The Chinese Biomedical Literature Database and Medline database 2003/2011 were searched to retrieve reviews and articles about bisphosphonate-induced osteonecrosis of the jaws to investigate and analyze its pathogenesis and clinical manifestation as well as its prevention and treatment. Based on patient’s history, laboratory examinations and specialist examination, one breast cancer patient with bone metastases was confirmed as having bisphosphonate-induced osteonecrosis of the jaws. This patient was cured following surgical-based treatments, and clinical results were satisfactory.
RESULTS AND CONCLUSION: A total of 15 articles related to bisphosphonate-induced osteonecrosis of the jaws were included. Bisphosphonates can inhibit osteoclasts, and reduce tumor cell-induced osteolytic bone metastases. In normal bone tissue, osteoblasts and osteoclasts maintain a homeostasis, but in the process of oral therapy, bisphosphonates inhibit the activity of osteoclasts in mandibular lesions, so that the pathophysiology process of bone remodeling cannot be completed. In addition, the repair for the jaw, especially the repair of alveolar bone in the alveolar surgery, cannot be done causing prolonged healing of the infection.