Clipping Board » Drug Poisoning ─ It is necessary to be aware of the toxic side effects before taking medication.
Update Date: 2008/07/28 09:19 [China Times, Zhang Cuifen / Taipei Report]
Taking common osteoporosis prevention drugs, bisphosphonates, may actually lead to jawbone necrosis? Dentists are urging patients who have been taking these types of medications for three years to undergo at least one full-mouth X-ray examination; if wounds from tooth extraction or dental implant surgery do not heal for a long time, they should be aware of potential drug side effects. Otherwise, severe jawbone necrosis may be difficult to remedy.
Bisphosphonates are the most commonly used drugs for treating osteoporosis, but there have been multiple cases abroad of their use leading to alveolar bone or maxillary bone necrosis, and similar cases have gradually appeared domestically as well.
After Three Years of Medication, At Least One Oral X-ray is Necessary
Dr. Li Zheng (Ji Ji), attending physician of the Oral and Maxillofacial Surgery Department at National Taiwan University Hospital, stated that in the past two to three years, he has treated more than twenty cases, most of whom were women in their sixties and seventies who had been taking osteoporosis medications and exhibited the aforementioned symptoms.
Why would osteoporosis medications, which are supposed to strengthen bones, cause dental problems instead? Dr. Li Zheng (Ji Ji) explained, bones contain osteoclasts and osteoblasts. Bisphosphonates inhibit the activity of osteoclasts, slowing bone loss. However, when there is a bone wound, such as from tooth extraction, alveolar bone transplantation before dental implants, or ill-fitting dentures pressing on the alveolar bone, if osteoclasts are inhibited, the bone-repairing function of osteoblasts is also hindered, preventing these dental bone wounds from healing and leading to necrosis.
The most severe case he encountered was a woman in her sixties who, after breast cancer cells metastasized to her bones, was injected with bisphosphonates, resulting in nearly one-third of her maxillary alveolar bone necrosing, nearly disfiguring her. Although she stopped the medication and underwent repeated surgeries, the necrosis continued, and efforts could only be made to prevent further deterioration.
Reserve Six Months of Medication-Free Time Before Dental Surgery
Dr. Li Zheng (Ji Ji) mentioned that at this year's related medical conferences on oral and maxillofacial surgery, three hospitals reported similar cases. Since these patients show no symptoms initially, with the first-level symptoms being only small wounds or pus, and wounds that do not heal easily, stopping the medication at this stage usually prevents further dental deterioration. However, if the damage is too severe, surgical removal of the necrotic bone is necessary.
Dr. Li Zheng (Ji Ji) recommends that those continuously taking osteoporosis medications should reserve a six-month medication-free period before and after dental treatments and oral surgeries, and consult their prescribing physician to evaluate alternative medications. Dr. Li Da Ming, Director of the Dental Department at Cardinal Tien Hospital, advocates that patients taking bisphosphonates should undergo a full-mouth X-ray after two to three years of continuous use to check if the jawbone has been damaged, and maintain good oral hygiene to prevent severe bone necrosis that could even prevent the use of dentures.
Source: http://tw. news. yahoo. com/ article/ url/ d/ a/ 080728/ 57/ 1eh. html
Bone Drugs Harm Jaw: Caution Needed for Tooth Extraction and Implants
Taking common osteoporosis prevention drugs, bisphosphonates, may actually lead to jawbone necrosis? Dentists are urging patients who have been taking these types of medications for three years to undergo at least one full-mouth X-ray examination; if wounds from tooth extraction or dental implant surgery do not heal for a long time, they should be aware of potential drug side effects. Otherwise, severe jawbone necrosis may be difficult to remedy.
Bisphosphonates are the most commonly used drugs for treating osteoporosis, but there have been multiple cases abroad of their use leading to alveolar bone or maxillary bone necrosis, and similar cases have gradually appeared domestically as well.
After Three Years of Medication, At Least One Oral X-ray is Necessary
Dr. Li Zheng (Ji Ji), attending physician of the Oral and Maxillofacial Surgery Department at National Taiwan University Hospital, stated that in the past two to three years, he has treated more than twenty cases, most of whom were women in their sixties and seventies who had been taking osteoporosis medications and exhibited the aforementioned symptoms.
Why would osteoporosis medications, which are supposed to strengthen bones, cause dental problems instead? Dr. Li Zheng (Ji Ji) explained, bones contain osteoclasts and osteoblasts. Bisphosphonates inhibit the activity of osteoclasts, slowing bone loss. However, when there is a bone wound, such as from tooth extraction, alveolar bone transplantation before dental implants, or ill-fitting dentures pressing on the alveolar bone, if osteoclasts are inhibited, the bone-repairing function of osteoblasts is also hindered, preventing these dental bone wounds from healing and leading to necrosis.
The most severe case he encountered was a woman in her sixties who, after breast cancer cells metastasized to her bones, was injected with bisphosphonates, resulting in nearly one-third of her maxillary alveolar bone necrosing, nearly disfiguring her. Although she stopped the medication and underwent repeated surgeries, the necrosis continued, and efforts could only be made to prevent further deterioration.
Reserve Six Months of Medication-Free Time Before Dental Surgery
Dr. Li Zheng (Ji Ji) mentioned that at this year's related medical conferences on oral and maxillofacial surgery, three hospitals reported similar cases. Since these patients show no symptoms initially, with the first-level symptoms being only small wounds or pus, and wounds that do not heal easily, stopping the medication at this stage usually prevents further dental deterioration. However, if the damage is too severe, surgical removal of the necrotic bone is necessary.
Dr. Li Zheng (Ji Ji) recommends that those continuously taking osteoporosis medications should reserve a six-month medication-free period before and after dental treatments and oral surgeries, and consult their prescribing physician to evaluate alternative medications. Dr. Li Da Ming, Director of the Dental Department at Cardinal Tien Hospital, advocates that patients taking bisphosphonates should undergo a full-mouth X-ray after two to three years of continuous use to check if the jawbone has been damaged, and maintain good oral hygiene to prevent severe bone necrosis that could even prevent the use of dentures.
Source: http://tw. news. yahoo. com/ article/ url/ d/ a/ 080728/ 57/ 1eh. html