Sir, I write regarding the News item on the use of a bisphosphonate (Risedronate) in periodontal disease (BDJ 2005; 199: 701).
While many drugs have potential beneficial effects, the question of potential adverse effects should always be considered. Readers may be aware that at least three of the family of bisphosphonates — Pamidronate, Zoledronate, and Alendronate — helpful in osteoporosis have been linked to severe oral adverse effects, especially painful necrosis of the jaw bones, sometimes described as osteochemonecrosis.1 This has been reported especially after dental extractions, but not invariably,2 and particularly in cancer patients on chemotherapy,3 especially intravenously.4 This adverse effect has been highlighted elsewhere.5 Mouth ulcers may also occasionally occur.6
References
Marx R E, Sawatari Y, Fortin M, Broumand V . Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 2005; 63: 1567–1575.
Merigo E, Manfredi M, Meleti M et al. Jaw bone necrosis without previous dental extractions associated with the use of bisphosphonates (pamidronate and zoledronate): a four-case report. J Oral Pathol Med 2005; 34: 613–617.
Bagan J V, Murillo J, Jimenez Y, et al. Avascular jaw osteonecrosis in association with cancer chemotherapy: series of 10 cases. J Oral Pathol Med 2005; 34: 120–123.
Ficarra G, Beninati F, Rubino I et al. Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment. J Clin Periodontol 2005; 32: 1123–1128.
[No authors listed] Alendronate (Fosamax) and risedronate (Actonel) revisited. Med Lett Drugs Ther 2005; 47: 33–35.
Gonzalez-Moles M A, Bagan-Sebastian J V . Alendronate-related oral mucosa ulcerations. J Oral Pathol Med 2000; 29: 514–518.
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Scully, C. Potential adverse effects. Br Dent J 200, 153 (2006). https://doi.org/10.1038/sj.bdj.4813249
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DOI: https://doi.org/10.1038/sj.bdj.4813249