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Bisphosphonates are either administered orally or intravenously. They reduce bone resorption. [31] Mechanism of action: Bisphosphonate binds to the mineral component of the bone and inhibits enzymes (i.e. farnesyl-pyrophosphate synthase) responsible for bone formation, osteoclast recruitment and osteoclast function. [29] [31]
Bisphosphonates, when administered intravenously for the treatment of cancer, have been associated with osteonecrosis of the jaw (ONJ), with the mandible twice as frequently affected as the maxilla and most cases occurring following high-dose intravenous administration used for some cancer patients.
The implication is that bisphosphonates may not be the initiating cause of ONJ and that other pre-existing or concurrent systemic and/or local dental factors are involved. [53] [54] Since ONJ has been diagnosed in many patients who did not take bisphosphonates, it is thus logical to assume that bisphosphonates are not the only factor in ONJ.
Nitrogen containing bisphosphonates are the current most used drugs in the class because of their potency. [15] Studies have showed that nitrogen on bisphosphonates forms hydrogen bond with threonine (Thr201) and the carbonyl part of Lysine (Lys200) on target enzyme, therefore enhancing the binding of the complex. Altering the position of ...
Other considerations to bone healing include the concurrent use of bisphosphonate, and denosumab, smoking, diabetes, immunocompromise, and infection. [5] Another consideration is the risk of bone and soft tissue loss on the subsequent implant in the long-term. Socket preservation has been associated with a greater risk of marginal bone loss [6]
Etidronic acid is a bisphosphonate used to strengthen bone, treat osteoporosis, and treat Paget's disease of bone.. Bisphosphonates primarily reduce osteoclastic activity, which prevents bone resorption, and thus moves the bone resorption/formation equilibrium toward the formation side and hence makes bone stronger on the long run.
It is given by injection into a vein. [3] Common side effects include fever, joint pain, high blood pressure, diarrhea, and feeling tired. [3] Serious side effects may include kidney problems, low blood calcium, and osteonecrosis of the jaw. [3] Use during pregnancy may result in harm to the baby. [3] It is in the bisphosphonate family of ...
In the early 2000s, a link between bisphosphonate use and impaired bone physiology was noted. [3] [4] The strong inhibition of osteoclast function precipitated by bisphosphonate therapy can lead to inhibition of normal bone turnover, leading to impaired wound healing following trauma (such as dental surgery) or even spontaneous non-healing bone exposure.