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Patients on Oral Bisphosphonates by Mind Map: Patients on Oral Bisphosphonates
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Patients on Oral Bisphosphonates

What are Bisphosphonates?

drugs aim to prevent bone resorption and remodeling

Who Take the drug?

Patient with bone resorption secondary to metastatic tumors

Osteolytic lesions



Side Effects

Capillary network in bone not maintained

Avascular bone necrosis


Bisphosphonates Related OsteoNecrosis of the Jaw (BRONJ)


Exposed, devitalized bone in maxillofacial regoin

Spontaneous or secondary sergery, trauma to oral soft tissue/bone

Stages of BRONJ

At Risk Category

Stage 1

Stage 2

Stage 3

Managment of Patient requring extractions

Taking the drug more than 3 yrs

Taking the drug less than 3 yrs

All need CHX MW 1 week before 1 week after

When the patient is safe ?

Complete healing

Updated Recommendations

Periodontal disease

Oral & Maxillofacial Surgery


Restorative & Prosthodontics



Bisphosphonates related osteonecrosis of the jaws (Nik desai 2010)

ISDH website

Oral Surgery ( Wiley 2010)

JADA 136 & 139