Abstract

The problem of prevention of medicinal osteonecrosis of the jaws is one of the lively discussions of the last decade in dentistry. Osteomodifying drugs (bisphosphonates, denosumab) most often cause medicinal osteonecrosis of the jaws. They are used to suppress resorption in osteoporosis, metastatic lesions of the bones of the skeleton, aseptic necrosis of the femoral and humerus heads, various genetic diseases accompanied by osteogenesis imperfecta and osteopenic syndrome. Due to the high prevalence of osteoporosis and malignant neoplasms in the population, the prescription of osteomodifying drugs has become a routine practice. Medicinal osteonecrosis of the jaws is an iatrogenic disease that is difficult to treat and leads to serious consequences in the form of a pathological fracture of the jaw, a chronic purulent-inflammatory process, and extensive defects in the jaw bone tissue. It is known that the most common drug osteonecrosis of the jaws occurs after tooth extraction surgery in patients taking osteo modifying drugs. To date, no method has been developed with proven efficacy that can completely prevent the disease, therefore, much attention is paid to measures that reduce the risks of complications. Providing surgical dental care to this category of patients is a difficult task. All of the above determined the task of researching and generalizing the basic principles of prevention of drug-induced osteonecrosis of the jaws in patients with a history of osteomodifying therapy, which are presented in this review.

Keywords: Bisphosphonates; Denosumab; Osteonecrosis; Tooth extraction