What do bisphosphonates like Zometa and Actonel do?
June 21, 2006 21:26

Let us first correct a common misperception - bisphosphonates do not cause the body to make more bone. They simply slow down the process of removing the dead bone cells from within the matrix by inhibiting the production of osteoclast cells (the cells that soften the bone). Thus, the body has more "hard" bone chambers than it would have, but it is at the cost of having fewer chambers housing healthy cells.

How do you treat ONJ?
June 22, 2006 21:32

Not much and thus prevention is key. There is no way to surgically reverse the damage done with a patient on who has treated with Bisphosphonates. With a patient who did not take Bisphosphonates, a doctor might simply remove the necrotic tissue and bone and stimulate the tissues to promote the tissue or bone to grow back. However, with a patient with comprised blood flow through the bone (reduced periosteal blood flow) as a result of Bisphosphonates having prevented healthy osteoblast from replacing mature osteoblast (osteoclast), the surgical procedure would tend to make the situation worse.