Why does fosamax cause osteonecrosis of the jaw

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This content does not have an English version. This content does not have an Arabic version. See more conditions. Request Appointment. Osteoporosis drugs: Risk of bone problems in jaw, thigh? Products and services. Can some types of osteoporosis drugs actually hurt my bones? Answer From Ann Kearns, M. Currently, guidelines from the American Association of Oral and Maxillofacial Surgeons do not include a recommendation for the prevention of osteonecrosis of the jaw in patients taking oral bisphosphonates for less than three years and in the absence of other systemic risk factors e.

Opponents of a drug holiday argue that, given the long half-life of bisphosphonates i. Some investigators have proposed measuring levels of serum C-terminal collagen peptides to stratify patients' risk of jaw osteonecrosis before dentoalveolar surgery.

Values less than pg per mL are considered high risk, whereas values greater than pg per mL represent minimal risk. There is a paucity of evidence-based recommendations for the treatment of bisphosphonate-related osteonecrosis of the jaw because treatment outcome is relatively unpredictable. The Canadian Task Force on Osteonecrosis of the Jaw and expert opinion do not support aggressive surgery.

Even though the risk cannot be eliminated, prognosis usually is good for patients with osteonecrosis of the jaw from oral bisphosphonates.

The area of bone exposure generally is limited 2 to 10 mm and of lesser severity, compared with patients with cancer who receive intravenous therapy. The optimal duration of bisphosphonate treatment for osteoporosis is uncertain. In a randomized controlled trial comparing five versus 10 years of alendronate Fosamax therapy, there were statistically significant improvements in bone mineral density and a lower risk of clinical vertebral fractures with 10 years of therapy.

However, there were no statistically significant differences in nonvertebral fractures or morphometric vertebral fractures. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Reprints are not available from the authors. National trends in osteoporosis visits and osteoporosis treatment, — Arch Intern Med.

Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws— update. Canadian consensus practice guidelines for bisphosphonate associated osteonecrosis of the jaw [published corrections appear in J Rheumatol. J Rheumatol. Stay on top of latest health news from Harvard Medical School.

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Caring for an aging parent? Tips for enjoying holiday meals. A conversation about reducing the harms of social media. Menopause and memory: Know the facts. Boniva has an I. Most of the ONJ cases connected to the use of bisphosphonates have involved zoledronic acid or pamidronate. Can you prevent osteonecrosis of the jaw? There is no known prevention of ONJ. However, to reduce the risk, all patients taking bisphosphonates should get regular dental checkups. Any infections in the mouth should be treated and any major oral surgery should be completed before starting bisphosphonates in people who are thinking about starting osteoporosis treatment.

Can doctors treat osteonecrosis of the jaw? While there is no specific treatment for ONJ, it can heal on its own with the help of antibiotic rinses and avoiding any other dental surgery. But healing is not guaranteed. Source : American College of Rheumatology Hotline. June 1,