The use of bisphosphonates does not contraindicate orthodontic and other types of treatment!

Abstract

Bisphosphonates have been increasingly used not only to treat bone diseases as well as conditions such as osteopenia and osteoporosis, but also in oncotherapy. The use of bisphosphonates induces clinicians to fear and care. These reactions are associated with controversy resulting from lack of in-depth knowledge on the mechanisms of action as well as lack of a more accurate assessment of side effects. Scientific and clinical knowledge disclosure greatly contributes to professionals' discernment and inner balance, especially orthodontists. Fear does not lead to awareness. For these reasons, we present an article that focuses on that matter. This article was adapted from different journals of different dental specialties, as mentioned on footnote. There is no scientific evidence demonstrating that bisphosphonates are directly involved with etiopathogenic mechanisms of osteonecrosis and jaw osteomyelitis. Their use is contraindicated and limited in cases of dental treatment involving bone tissue. Nevertheless, such fact is based on professional opinion, case reports, and personal experience or experiment trials with failing methods. Additional studies will always be necessary; however, in-depth knowledge on bone biology is of paramount importance to offer an opinion about the clinical use of bisphosphonates and their further implications. Based on bone biopathology, this article aims at contributing to lay the groundwork for this matter.

The Effect Of Bisphosphonate Risedronate Emulgel On The Inhibition Of Relaps Tooth Movement

“…18 Alveolar bone has one of the cells that play an important role in the occurrence of relapse, namely osteoclasts, 19 influencing mineral exchange processes during bone resorption. 21 Hence, post-orthodontic therapy with BP administration can reduce alveolar bone resorption so that the tooth becomes stable in the alveolar bone and can control relapse. 22 The 23 Therefore, bisphosphonates are needed, which can be administered topically so that the active drug substance is easily absorbed by the oral mucosa without pain.…”

Dental management of a child with a rare bone disorder: a case report with a six-year follow up

“…The aim of such treatment is to reduce the risk of associated fractures and inhibit bone resorption, thereby reducing pain intensity and the occurrence of fractures as well as improving mobility [8,27]. There is no evidence in the literature to contraindicate orthodontic treatment for individuals in bisphosphonate therapy [28]. The recovery of oral function and esthetics is fundamental to the enhancement of self-esteem and patient satisfaction as well as for a better performance on activities of daily living, leading to an improvement in quality of life [20,23].…”

Bisphosphonates

“…Curiously, this is also supported by another study 8 of which findings revealed that implant surfaces coated with BP led to greater implant osseointegration and reduced marginal bone loss throughout the first six months after implant placement. Consolaro 9 asserts that the use of bisphosphonates induces clinicians to fear and care. These reactions are associated with controversy resulting from lack of deep knowledge on the mechanisms of action as well as lack of a more accurate assessment of side effects.…”