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AAO-HNSF: 'Bone Death' of Jaw Seen As Emerging Threat

Symposium addresses prevention and treatment strategies for bisphosphonate osteonecrosis

FRIDAY, Sept. 26 (HealthDay News) -- An increasing number of older Americans are likely to develop a serious complication of bisphosphonate therapy -- "bone death" of the jaw -- according to "The Emerging Epidemic? The Management of Bisphosphonate Osteonecrosis," a symposium presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO held Sept. 21 to 24 in Chicago.

D. Gregory Farwell, M.D., of the University of California-Davis, moderated a panel discussion including three other physicians and one dentist. They discussed prevention strategies such as preoperative work-ups and closer collaboration with the dental community. They also discussed treatment strategies, including non-surgical interventions such as hyperbaric oxygen therapy and surgical interventions such as microvascular reconstruction.

Although bisphosphonate osteonecrosis was first described only five years ago, the panelists pointed out that there are rapid and increasing numbers of case reports. They said that an estimated 44 million Americans over age 50 are candidates for bisphosphonate therapy, which is associated with a bisphosphonate osteonecrosis risk of 0.09-0.34 percent for oral dosing and a significantly higher risk for intravenous dosing.

"While this is a relatively rare phenomenon, the large number of patients at risk makes the number of patients that may develop this disease highly significant," Farwell and colleagues state. "A consensus for treatment of this challenging disease entity is starting to emerge with recent guidelines issued by both the American Dental Association and the American Association of Oral and Maxillofacial Surgery."

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