Serious oral post-surgical complication identified in patient on prescribed therapy for osteopenia

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Contact: Kerry Gutshall

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312-573-3243

American Academy of Periodontology

Serious oral post-surgical complication identified in

patient on prescribed therapy for osteopenia

Patient who received IV bisphosphonates associated

with treatment for breast carcinoma develops

osteonecrosis following periodontal surgical therapy

Chicago – The patient of a periodontist in private

practice in New Orleans developed osteonecrosis of the

jaw (ONJ), a condition that can cause severe, often

irreversible and debilitating damage to the jaw,

following periodontal surgical therapy. Two years

prior to surgery, the patient had started receiving IV

bisphosphonate therapy, or bone-sparing drugs commonly

used in the treatment of osteoporosis and metastatic

bone cancer to help decrease associated pain and

fractures, following treatment for breast carcinoma.

When the patient presented to the periodontist, no

reports of ONJ had been reported in the literature.

This case report is published in the April issue of

the Journal of Periodontology (JOP).

" It is counter-intuitive to believe that bone-sparing

drugs such as IV bisphosphonates can have the opposite

affect and actually necrotize the jaw bone, " said

Kristi M. Soileau, DDS, case report author and member

of the American Academy of Periodontology (AAP).

" While we're not sure exactly why this happens, one

possibility is that the drug compromises the vascular

supply, which contributes to non-healing or the

development of a diseased wound once the bone is

exposed such as with extractions or with oral

surgery. "

" It is important that our colleagues in dentistry and

medicine are aware of this potential complication in

this large and growing population of patients for whom

IV bisphosphonates are being prescribed, " explained

A. Krebs, DMD and AAP president. " A complete

dental examination, including a periodontal

evaluation, should be performed before a patient

begins IV bisphosphonate therapy to identify and

address any oral conditions, as recommended with

preradiation patients, " added Soileau.

The case report did not include information related to

patients taking oral bisphosphonates, which are more

relevant to osteoporotic concerns.

Additional information about IV bisphosphonates and

osteonecrosis is available through the Academy's Web

site at

http://www.perio.org/resourcesproducts/bisphosphonates.htm.

The American Academy of Periodontology is an

8,000-member association of dental professionals

specializing in the prevention, diagnosis and

treatment of diseases affecting the gums and

supporting structures of the teeth and in the

placement and maintenance of dental implants.

Periodontics is one of nine dental specialties

recognized by the American Dental Association.

EDITOR'S NOTE: A copy of the case report " Oral

Post-Surgical Complications Following the

Administration of Bisphosphonates Given for Osteopenia

Related to Malignancy " is available to the media by

contacting the AAP Public Affairs Department at

312/573-3243, and an abstract is available online

http://www.joponline.org/doi/abs/10.1902/jop.2006.050187.

The public and/or non-AAP members can view a study

abstract online, and the full-text of the study may be

accessed online for $20.00 at

http://www.joponline.org/.