Bisphosphonates and the field of dentistry

AbstractBisphosphonates are the drugs used to prevent loss of bone and to treat bone diseases and conditions that feature bone fragility. Bisphosphonates, according to the potency levels, are divided into three generations and potency levels have increased with successive generations and, according to mechanism of action, they are divided into Non-nitrogenous and Nitrogenous bisphosphonates. Clinically, nitrogen containing bisphosphonates are more potent. Oral bisphosphonates are safer than intravenous infusion. Oral bisphosphonates may cause recurrent ulcers with burning sensation and blisters in the oral cavity, while intravenous bisphosphonates may cause renal failure. The most serious complication of intravenous bisphosphonates is osteonecrosis of jaw bones especially after tooth extraction. Endodontic therapy is not a significant risk factor for promoting bisphosphonates-related osteonecrosis, so endodontic therapy can be an alternative to tooth extraction when possible. Regarding treatment, parathyroid hormone can be helpful because it stimulates bone formation by promoting bone turnover.