Dental Education
Online Dental Education Dental education lectures and videos Online dental ce Dental education articles Expert dental educators Dental products education Dental Community
 
Dental Publication / Article Details

Bisphosphonates and Their Impact on Patient Treatment Bisphosphonates and Their Impact on Patient Treatment

Author(s):

Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS, John Peden, DDS

Date Added:

7/18/2008


Summary:

There has been increasing discussion concerning a variety of implications for patients who have been administered bisphosphonates, which are FDA-approved chemical agents used in the treatment of osteoporosis, metastatic cancer involving the bone, and Paget's disease. I The first report of the biological characteristics of bisphosphonates was published in 1968, when scientists discovered that bisphosphonates have a marked ability to inhibit bone resorption. Bisphosphonates suppress or reduce bone resorption by osteoclasts by hindering the recruitment and function of osteoclasts and by sti mulating osteoblasts to produce an inhibitor of osteoclast formation. Though they suppress the abnormal bone resorption and pain associated with Paget's disease, fibrous dysplasia, and metastatic bone cancer, bisphosphonates do not cure disease. There is increasing evidence, however, that patients who have been treated wi th bisphosphonates may be susceptible to osteonecrosis associated with dental surgical procedures such as extractions, implant placement, and infections involving cran iofacial bone. It has been suggested that these changes may leave the patient more susceptible to osteonecrosis, are long term, and cannot be reversed by discontinuing usage of the medication. Bisphosphonates inhibit bone resorption and thus bone renewal by suppressing the recruitment and activity of osteoclasts, thus shortening their lifespan. In a study of 119 cases of bisphosphonate-related bone exposure, Marx reported that dental comorbidities were found including the presence of periodontitis (84%), dental caries (28.6%), abscessed teeth (13.4%), root canal treatments (10 9%), and mandibular tori (9 2%) The precipitating event that produced the bone exposures were extractions (378%1, advanced periodontitis (28.6%), spontaneous occurrences (25.2%), periodontal surgery (11.2%), dental implants (3.4%), and root canal surgery (0.8%).

Related Articles
Implications of Bisphosphonate Use for the Dentist

Implications of Bisphosphonate Use for the Dentist
The authors look into the research studies into bisphosphonates, the important classification of drugs for the treatment of bone diseases. Are bisphosphonates safe when used during or around implant treatment? The authors have some good news for us.

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD;Gregori M. Kurtzman, DDS, John Peden, DDS, Peter C. Shatz, DDS
View Article>>
Improving Diagnosis Through the Use of Digital Radiography

Improving Diagnosis Through the Use of Digital Radiography
As aesthetic dentistry has gained in popularity among consumers, who are more aware of the potential it has to correct deficiencies in their smiles, practitioners are challenged to improve the nature of their treatment. Often, this entails providing treatment with a smaller associated expense, reduced treatment duration or expense, and with increased comfort to the patient throughout the procedure. Facing these imperatives, greater numbers of practitioners have opted to incorporate digital communications…

Author(s): Lee H. Silverstein, DDS, MS, FACD, FICD
View Article>>
Legal Considerations  in the use of Cone  Beam Computer Tomography Imaging

Legal Considerations in the use of Cone Beam Computer Tomography Imaging
Cone beam computed tomography imaging represents a paradigm shift for enhancing diagnosis and treatment planning. Questions regarding cone beam computed tomography’s associated legal responsibility are addressed, including cone beam computed tomography necessity, recognition of pathosis in the scan’s entire volume, adequate training, informed consent and/or refusal and current court status of cone beam computed tomography. Judicious selection and prudent use of cone beam computed tomography technology to protect and promote patient safety and efficacious treatment complies with the standard of care.

Author(s): Edwin J Zinman, DDS, JD;Stuart C. White, DDS, PHD; and Sotirios Tetradis, DDS, PHD
View Article>>
Related Videos
The Clinical Relevance of Digital Dentistry & 3D Technologies Premium Member Content

The Clinical Relevance of Digital Dentistry & 3D Technologies
The implementation of modern digital technologies into the clinical practice requires a step by step process. Photography, optical scanning and stitching of CBCT images allow for Digitally rendered smile designs that then lead to guided procedures and 3D printing of mockups, provisionals and surgical guides. This presentation will highlight the role of digital dentistry in a modern dental office and the steps required to prepare oneself for this evolution. 

Presented By:: Marko Tadros, DMD
Presentation Style: Video
Community Rating:
 
Watch Now>>
OCCLUSION: Can We Possibly Simplify It? - Part 1 Premium Member Content

OCCLUSION: Can We Possibly Simplify It? - Part 1
Over the past 20 years, many of us have been confused, frustrated, unsure and crazy about ... “How do I get my occlusion philosophy on the right path?” At NYU FMR we have developed tried and true techniques that are guaranteed to make you understand occlusion, contact points and mandibular movement that makes sense, is easy to diagnose and systematically treat with success. In addition being comfortable Restoring OVD, understanding TMJ joint position and treating the worn dentition. Using our SOT methods and Level 1-10 Occlusion Classification we can show you how to become successful in the “Occlusion” of your patients.

Presented By:: Dean C. Vafiadis, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
How to Take Ideal Impressions For The Best Outcomes Premium Member Content

How to Take Ideal Impressions For The Best Outcomes
Taking accurate, detailed impressions are vital to the submission of a case to Invisalign. Even the most experienced clinician can encounter difficulties. Choosing the correct impression materials, patient positioning, Tray insertion and mixing, working and setting times. In this course we will also trouble shoot all areas of what we call bad impressions such as bubbles, tears, pulls, voids and tray contact.

Presented By:: Shannon Pace Brinker, CDA, CDD
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
The Smile Design Revolution - Management, Communication and Implementation Premium Member Content

The Smile Design Revolution - Management, Communication and Implementation
Treatment planning a full mouth rehabilitation is amazingly challenging. So many options and steps must be coordinated and controlled to achieve a successful outcome. Developing the Smile Design is just the starting point. Carefully integrating this design to function is the key. This presentation will show how this process is a complex brainstorm that needs to be guided by logical and rational steps to achieve consistent and predictable solutions.

Presented By:: Christian Coachman, DDS, CDT
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
CBCT in Endodontics: Changing the Landscape of Diagnosis and Clinical Treatment Premium Member Content

CBCT in Endodontics: Changing the Landscape of Diagnosis and Clinical Treatment
Radiographic imaging is essential in the diagnosis, treatment planning and follow-up in endodontics. The interpretation of an image can be confounded by a number of factors, including the regional anatomy as well as superimposition of both the teeth and surrounding dento-alveolar structures. As a result of superimposition, periapical radiographs reveal only limited aspects, a 2-dimensional view, of the true three dimensional anatomy. Additionally, there is often geometric distortion of the anatomical structures being imaged with conventional radiographic methods. These problems can be overcome by utilizing small or limited volume cone beam computed tomography (CBCT) imaging techniques which produce accurate 3-dimensional images of the teeth and surrounding dento-alveolar structures. This presentation will highlight the indications, advantages and considerations of the use of CBCT in endodontics.

Presented By:: Frederic Barnett, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 CEU (Continuing Education Unit)
Watch Now>>
Dental Photography: From Theory to Practice Premium Member Content

Dental Photography: From Theory to Practice
Dental photography should be your daily tool. If not, don’t wait and take your steps to learn it and master it. In this lecture, you will see how to take step by step full dental portfolio and which instruments are helpful in surgical photo documentation. In the end, you will get an update in settings, equipment, and accessories used to take excellent dental photo documentation.

Presented By:: Kris Chmielewski, DDS, MSc
Presentation Style: Online Self-Study Course
CE Hours: 1 Continuing Education Unit (CEU)
Watch Now>>
Download Now

Important!

To view this dental publication or article, you must be a registered user of Dental XP. If you are already a member, click here to login.

Registration is free and only takes several minutes. Dental XP will never spam you, or sell your information.

Join For Free





Contact Us | Privacy Policy | Terms of Use
©2018

Preferred Language: English Flag
Contact Us · Login · Register