Principles of therapy inside the oral cavity in patients treated with bisphosphonates

Comprehensive treatment with bisphosphonates in patients suffering from either oncogenous diseases or osteoporosis may adversely

affect the bone tissue of the jaw and thus, osteonecrosis might occur after teeth extractions or other surgical interventions. Bone wounds

would not heal up and necrotic bone edges are exposed into the oral cavity. At first the treatment of the affected area is performed in

a considerate conservative way, later on surgical treatment and removal of necrotic and disengaging bone parts is carried out. Targeted

compound antibiotic medication is indicated on account of the prevalence of anaerobic microflora present in the area. Like in oncogenous

patients in whom the jaw is going to be treated with radiotherapy, thorough stomatological examination and indicated teeth extractions

are necessary to be accomplished from the preventive time point of view before the scheduled treatment with bisphosphonates

is going to start. Treatment of complications is carried out by specialists, i. e. maxillofacial surgeons.

Keywords: osteonecrosis of the jaw, bisphosphonates, preventive and treatment procedures.