Anti-resorptive treatment in osteoporosis and their deleterious effects on maxillary bone metabolism in clinical dentistry

Bisphosphonates (BPs) and other antiresorptive agents such as denosumab are widely prescribed for the treatment of osteoporosis and are also used in patients with multiple myeloma and metastatic breast or prostate cancer for avoiding bone reabsorption and fractures that result in increased morbidity–mortality among such individuals. Osteonecrosis of the jaws is an important complication of exposure to BPs or other antiresorptive agents, and although its prevalence is low, it can pose management problems. The definition, diagnosis, and classification of osteonecrosis have evolved since Marx reported the first cases in 2003. The present chapter offers a review and update on the existing diagn…