Dentist's role in preventing biphosphonates induced osteonecrosis [Ruolo dell' odontoiatra nella prevenzione dell' osteonecrosi da bifosfonati]

The bisphosphonates are good inbibitors of osteoclastic activity and have antiangionenic properties. They are used in the treatment of post-menopausal osteoporosis, Paget's disease and malignant hypercalcemia. Some bisphosphonates, such as pamidronate or zoledronate, are stronger and are indicated in the treatment of breast and prostate cancer in order to reduce the risk of bone metastasis, and in the treatment of multiple myeloma for bone resorptive defects and to prevent pathological fractures. Recently several Authors have reported cases of jaw osteonecrosis in patients treated with bisphosphonates. The dentist may play an important role in preventing this complication induced by bisphosphonates through diagnosis and control of oral diseases. It is necessary that patients have good oral health before being treated with bisphosphonates.