OSTEOPOROSIS

One of the major skeletal diseases in older age, is characterised by low bone mass and micro-architectural deterioration with a resulting increase in bone fragility and hence susceptibility to fracture. Systemic factors most often correlated with the oral bone mass loss include osteoporosis, renal diseases, hormonal disorders, diet and the impact of different drugs on the bony structure. Chronic periodontal disease, early loss of teeth and residual ridge atrophy are some of the local factors associated with osteoporosis.

Bisphosphonate medications are widely used in the treatment of bone diseases including osteoporosis and Paget’s disease and in some cancers. They are used in low oral doses to treat osteoporosis and to prevent fractures. They are used in high IV (intravenous) doses in cancer to prevent complications when it spreads to bone.

Osteonecrosis of the jaw (ONJ) is a very rare side effect of bisphosphonates. However, you should be aware of this rare but potentially serious association of bisphosphonate treatment and take appropriate measures to help prevent it.

Osteonecrosis means death of bone. Osteonecrosis of the jaw (ONJ) is defined as an area of exposed bone (not covered by gum) in the jaw region that does not heal within 8 weeks of identification. The exact cause of ONJ is currently unknown.

The risk of developing bisphosphonate-associated ONJ ranges between 1/10,000 to 1/100,000 for patients taking oral bisphosphonates for treatment of osteoporosis or Paget’s disease. The risk is much higher, ranging between 1% and 10%, for patients with cancers on high IV doses.