Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2008, vol. 17, nr 5, September-October, p. 575–581

Publication type: review article

Language: English

Osteonecrosis of the Jaws Associated with Administration of Bisphosphonates

Martwica kości szczęk związana ze stosowaniem bisfosfonianów

Marcin Kos1,, Klaudiusz Łuczak2,

1 Department of Maxillofacial Surgery Klinikum Minden, Minden, Germany

2 Department of Maxillofacial Surgery, Silesian Piasts University of Medicine in Wrocław, Poland


Bisphosphonates (BPs) are pyrophosphate analogues with oxygen/carbon exchange in the basic chain and two additional substitutes by the central carbon atom. Their unique chemical structure determines their ability to inhibit bone resorption by selective adsorption to mineral surfaces, subsequent internalization in osteoclasts, and impairment of their function. BPs have been successfully used for several years to treat skeletal events in neoplasia, hypercalcemia of malignancy, osteoporosis, Paget’s disease, osteogenesis imperfecta, and fibrous dysplasia. Recently, bisphosphonate−related osteonecrosis of the jaws has been reported as a serious complication of therapy with these drugs; however, there is limited scientific understanding of this condition. This paper outlines current views on the etiology, pathogenesis, risk factors, and management strategies related to bisphosphonate−associated jaw bone osteonecrosis.


Bisfosfoniany są analogami pirofosforanów charakteryzującymi się wymianą atomu tlenu na atom węgla w łańcuchu podstawowym i obecnością dwóch podstawników przy centralnym atomie węgla. Unikatowa struktura chemiczna warunkuje ich zdolność do hamowania resorpcji kostnej przez wybiórczą adsorpcję do składników mineralnych, internalizację przez osteoklasty i zaburzenie ich funkcji. W ciągu ostatnich kilkunastu lat bisfosfoniany były z powodzeniem stosowane w leczeniu objawów kostnych w chorobach nowotworowych, hiperkalcemii, osteoporozy, choroby Pageta, wrodzonej łamliwosci kości (osteogenesis imperfecta) i dysplazji włóknistej. Ostatnio pojawiły się doniesienia o występowaniu martwicy kości szczęk związanej ze stosowaniem bisfosfonianów, naukowe podstawy tego zjawiska nie zostały jednak w pełni wyjaśnione. W artykule nakreślono aktualne poglądy na etiologię, patogenezę, czynniki ryzyka oraz leczenie martwicy kości szczęk związanej z leczeniem bisfosfonianami.

Key words

bisphosphonates, osteonecrosis, osteomyelitis, jaw

Słowa kluczowe

bisfosfoniany, martwica kości, zapalenie kości szczęk

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