Bisphosphonates and bone pharmacology in dentistry
University of Rome, Italy
: Dent Health Curr Res
The bisphosphonates are similar to pyrophosphate, knowns for their use against senile osteoporosis, Paget’s illness and for the prevention of the vanishing bone disease, linked with some kind of tumors. Among dentists, are present several worries and maybe most of them are pointless. This problem must be object of specific studies but for me it is important to underline that the risk of osteonecrosis, must be evaluated inside the overall picture of the patient, thereby is fundamental the dentists history. Osteonecrosis shows up mostly among the cancer patients that assumes systemically high doses of bisphosphonates of second and third generations, the most powerful because they contain amino group. In those cases, a pile up of phosphorus could bring a closure of bone turnover and the antiangiogenic effect linked to this uses could block the local vascularization. All of this make the mouth particularly vulnerable to osteomyelitis; in addiction, the chemical-avascular osteonecrosis caused by bisphosphonates could bring extremely serious problems. However, we must remember that osteonecrosis is not frequent as phenomenon: The bisphosphonates are taken with regularity by millions of patient, under the fifty’s the cases are rare, no cases are detected during pediatric age on child in therapy with bisphosphonates for imperfect osteogenesis, the juvenile idiopathic osteoporosis and the fibrous dysplasia of the bone.