Bisphosphonates, a class of drugs commonly used for osteoporosis, have recently included a new addition to their list of side effects, osteonecrosis of the jaw (ONJ) or jawbone death. The Pennsylvania Dental Association (PDA) would like to inform the public about this rare but very serious side effect of bisphosphonates. Some drugs within this class include Fosamax, Actonel, and Boniva, taken orally. Other drugs include Aredia, Bonefos, Didronel, or Zometa which are administered intravenously. Over a thousand cases of ONJ have been reported in patients undergoing bisphosphonates treatments. Unfortunately, the action by bisphosphonates may disrupt the delicate balance of osteoclasts and osteoblasts in the jaws of some patients, inhibiting new vessel formation and thereby impairing healing after oral surgery. This can lead to the death of bone tissues and result in osteonecrosis. Most cases of osteonecrosis of the jaw associated with bisphosphonates have been diagnosed after dental procedures such as tooth extractions; however, the condition also can occur spontaneously.
Symptoms of ONJ include, but are not limited to, pain, swelling, or infection of the gums or jaw; gums that are not healing; loose teeth; numbness or a feeling of heaviness in the jaw, drainage, and exposed bone.
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