Bone Necrosis

Bone Necrosis

If part of the bone is dead, then we are talking about osteonecrosis. The factors that can cause jaw bone necrosis are:

1) Infection

2) Radiation (for cancer treatment)

3)Medicines e.g. bisphosphonates, chemotherapeutics, cortisone, antiangiogenics , antiosteoclasts .

In recent years, the condition of jaw bone necrosis following the administration of bisphosphonates (BRONJ) has been gaining scientific interest due to the increasing incidence. The most common bisphosphonates are: aledronic acid (eg Fosamax), Zoledronic acid (eg Alcasta, Zometa), pamidronic acid (eg Aredia) and ibandronic acid (eg Bonviva).

The typical symptom of bisphosphonate jaw necrosis is the exposure of the bone to the mouth for weeks without a tendency to heal (and of course, the bisphosphonate patient intake).

Other clinical symptoms may include pain and numbness in the area, inflammation of the sinuses and even abnormal jaw fracture.

Bisphosphonate necrosis can be triggered by tooth extractions or other oral surgeries. This is why it is essential that patients taking these medicines have a high level of oral hygiene and treat their dental conditions in time before they end up requiring surgical treatment.

If osteonecrosis develops despite preventive measures, we recommend surgical treatment for the following reasons:

1) The diagnosis is confirmed by the sample of surgery

2) Progression of necrosis is hampered by surgery

3) Surgical treatment has a higher success rate than conservative treatment.

Surgical treatment consists essentially in the removal of abnormal and necrotic bone and in the plastic repair of the area. The regimen is supplemented by antimicrobial treatment (antibiotics) and oral hygiene instructions.

If you are taking medicines in these categories and would like to discuss if and how likely you are to develop bone necrosis do not hesitate to contact me. If you also take these medicines and are interested in implantation, I’ll be happy to let you know. And of course, in collaboration with your treating physician (the doctor prescribing these medicines), we can discuss whether it is useful for you to continue the treatment or it may be modified.

It goes without saying that if bone necrosis is already present or if you suspect something is wrong, I will be undergoing surgical treatment and rehabilitation. I’m willing to help.