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Bisphosphonate drugs and their relevance to dentistry

The Dental Implant Clinic team member Elliott Ballantyne completed his MSc thesis on the use  of bisphosphonates in dentistry. He is presenting a poster on the subject at the international Osteology Conference in Monaco this April.

Bisphosphonates are a group of drugs used to treat a variety of disorders. One of the most common uses for this drug is to treat the condition of osteoporosis and osteopenia (pre-osteoporosis). They can also be given after the treatment of certain cancers such as breast cancer and prostate cancer.

There are several types of bisphosphonate:

Disodium pamidronate (Aredia)
Ibandronic acid or ibandronate (Bondronat)
Sodium clodronate (Bonefos, Clasteon, Loron)
Zoledronic acid or zoledronate (Zometa)

The bisphosponates work by targeting areas of higher bone turnover and slowing the rate of bone loss which is caused by cells in the bone called osteoclasts. The bisphosphonate drugs  are absorbed by the osteoclasts which slows down their activity and reduce bone loss. However, the slow down of bone loss caused by bisphosphonate drugs also reduces the rate of bone healing. This can sometimes be a problem if if you need to have a tooth extracted or need dental implants.

May people who are already taking bishphosphonates can still have a tooth extraction or a dental implant because it depends on the dose, type of bisphosphonate and how long you have been taking it for.

Some important points to note are:

  • Tell your dentist if you have started or about to start these drugs
  • Before taking these drugs it is best to have a thorough check up to ensure that your teeth and implants are healthy

Below is a copy of Elliot’s poster (click to enlarge – note: contains clinical imagery).

Bisphosphonates