Sir, bisphosphonates are widely used for their undoubted beneficial effects such as protection against bone fractures in osteopenic or osteoporotic people. Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is one possible adverse effect – an avascular area of necrotic bone in the maxillofacial area, with or without exposed bone, that has been evolving for more than eight weeks in patients without a previous history of irradiation in the maxillofacial region and is seen mainly in people receiving intravenous BPs, used largely to treat hypercalcaemia in people with malignant disease.1,2,3 There is a huge literature on this aspect of relevance to dentistry. Patients not infrequently seek advice on this medication, and their decisions may be influenced by other drug effects.
As with many new drugs, other adverse effects of bisphosphonates are increasingly being recognised, with atypical bone fractures,4 atrial fibrillation,5 cancers (oesophageal and colorectal)6 and now possibly inflammatory eye effects such as scleritis and uveitis7 appearing in the ever-lengthening list of potential adverse effects. Potential users may wish to consider these issues when deciding on medication.
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Scully, C., Robinson, A. Bisphosphonate considerations. Br Dent J 212, 520–521 (2012). https://doi.org/10.1038/sj.bdj.2012.477
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DOI: https://doi.org/10.1038/sj.bdj.2012.477
