Universal Journal of Clinical Medicine Vol. 2(2), pp. 35 - 42
DOI: 10.13189/ujcm.2014.020201
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Improving Inter-Professional Communication among Medical and Dental Providers Treating Bisphosphonate Therapy Patients May Reduce the Risk of Osteonecrosis of the Jaw


Tena Dischler 1,*, Jeffrey L. Alexander 2, Denice Curtis 2, Michael Markson 3
1 Private General Dental Practice, 10814 N 71st Place, Scottsdale, Arizona 85254.
2 Department of Interdisciplinary Health Sciences, A.T. Still University, 5850 East Still Circle, Mesa, Arizona 85206
3 Private Endodontic Practice, 10802 North 71st Place, Scottsdale, Arizona 85254

ABSTRACT

While large clinical trials have shown rare adverse side effects in post-menopausal women taking uninterrupted oral bisphosphonates (BPs), there is mounting evidence that longer-term treatment may be associated with osteonecrosis of the jaw (ONJ). There is a paucity of information regarding the causal relationship between extended oral BP treatment and ONJ, and the safety of non-surgical therapy of apical lesions and length of treatment in women on long-term BPs. We describe a post-menopausal woman on long-term oral BPs who developed ONJ without any contributory risk factors. Quantitative data was gathered through review of the patient’s medical record. Qualitative data was gathered from face-to-face interviews with patient and clinician. Analysis of the data revealed the patient did not feel it was important to report her use of BPs. Given the wide usage of antiresorptives dental clinicians should manage all post-menopausal women with the assumption they currently or have recently been treated with BPs. There is a need for a collaborative effort by medical and dental practitioners to reduce risk of ONJ, ensure proper BP dosing and length of treatment, identify contributory risk factors, and explore alternate modalities, such as Ca(OH) 2 multi-visit palliative pulpectomy, to avert ONJ and improve treatment outcomes.

KEYWORDS
Bisphosphonates. Antiresorptives. Osteonecrosis of the Jaw. ONJ. Pulpectomy

Cite this paper
Tena Dischler , Jeffrey L. Alexander , Denice Curtis , Michael Markson . "Improving Inter-Professional Communication among Medical and Dental Providers Treating Bisphosphonate Therapy Patients May Reduce the Risk of Osteonecrosis of the Jaw." Universal Journal of Clinical Medicine 2.2 (2014) 35 - 42. doi: 10.13189/ujcm.2014.020201.