Bisphosphonate–induced osteonecrose of the jaws in patients with osteoporosis

Bisphosphonate–induced maxillary osteonecrosis represents a pathology of the oral cavity characterized by the presence of ulcerations, exposure of necrotic bone tissue and secondary complications. Purpose: to evaluate the effectiveness of preventive measures and treatment plan of bisphosphonate–induced maxillary osteonecrosis in patients with osteoporosis. Material and methods: In the study there are 3 female patients — DE — 65, LV — 85 and VM — 73 years of age respectively, to whom bisphosphonates were administered, two of them — orally and one — intravenously. The following investigations were performed: clinical, radiological examination (OPG and CBCT), osteodensitometry and beta–cross–laps bone marker analysis, and rheumatologist consultation. Results: Examination and treatment of patients was performed in 2 cases, with follow up for 1 year on average. The beta–cross–laps bone marker was respectively: DE–0.26 ng/mL, LV–0.22 ng/mL, VM–0.24 ng/ mL. Radiological examination revealed signs of sinusitis, irregular bone margins, increased porosity and in one clinical case — bone fragment detachment. Medicinal and surgical treatment was carried out for issues in the oral cavity. Conclusion: Early detection of bisphosphonate–induced osteonecrosis, as well as interdisciplinary collaboration with the physician rheumatologist, results in a decrease in the occurrence of secondary complications.