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Bisphosphonates Meds

Q:What are bisphosphonates?

Bisphosphonates are class of drugs to treat Osteoporosis most commonly in women or people who has less calcium.

Q:Name some Bisphosphonate drugs?

Actonel (Risedronate- Generic Name), Atelvia ( Risedronate), Boniva (Ibandronate), Bonefos(Clodronate), Bonviva( Ibandronate), Didronel( Etidronate), Fosamax( Alendronate), Skelid (Tiludronate), Prolia(Denosumab), Xgeva(Denosumab),Teriparatide, Odanacatib,Reclast, Aclast, Zometa( Zoledronic Acid).

Q:How are Bisphosphonates related to my Dental Extractions?

Among patients taking Bisphosphonates especially Intravenously when dental procedures like extractions and other bone related surgeries are performed they are more prone for Osteonecrosis of Jaw Bone and this is most commonly referred to as Bisphosphonates Related Osteonecrosis of Jaw Bone or BRONJ. Osteonecrosis means the site where surgery is performed does not heal and presents with symptoms of severe pain and bleeding surfaces and needs extensive surgery to correct the complications or sometimes patients have to live with it.

Q:What should I do if I am taking Bisphosphonates?

Discuss your situation with your Dental treatment provider and he may coordinate with your Physician and discuss the best way to treat you. Sometimes you may need to get some Bone density tests done like T-Score, NTx, CTx.

Q:What are the symptoms and staging of BRONJ?

Pain, Soft tissue swelling, infection, loosening of the teeth, halitosis and drainage and exposed bone.

AAOMS Staging

Category   Criteria  
At Risk Clinically normal, asymptomatic patients who have received antiresorptive therapy
Stage 0 No clinical evidence of exposed bone, but presence of non-specific symptoms or clinical and/or radiographic abnormalities
Stage 1 Exposed and necrotic bone in patients who are asymptomatic and have no evidence of infection
Stage 2 Exposed and necrotic bone associated with pain and/or signs of infection in the region of bone exposure with or without purulent drainage
Stage 3 Exposed and necrotic bone in patients with pain, infection, and at least one of the following: exposure and necrosis extending beyond the local alveolar tissues; radiographic evidence of osteolysis extending to the inferior mandibular border or the maxillary sinus floor; pathologic fracture; oro-antral, oro-nasal or oro-cutaneous communication