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Article: Volume 42 Number 5 Page 436 - June 2015

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  Dent Update 2015; 42: 436-440

Oral surgery:  Denosumab, an Alternative to Bisphosphonates but also Associated with Osteonecrosis of the Jaw – What is the Risk?

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Abstract: Most dental professionals will have, or will soon, encounter patients prescribed this novel alternative antiresorptive drug to bisphosphonates, denosumab (Prolia®, Xgeva®). Denosumab is licensed in the UK for the prevention of osteoporotic fractures in postmenopausal women and the prevention of skeletal-related events (SRE) in adults with bone metastases. The presence of osteonecrosis of the jaw in patients receiving non-bisphosphonate antiresorptives has led to the introduction of the term antiresorptive-related osteonecrosis of the jaw or ARONJ. This paper discusses the basic physiology of bone remodelling, the pharmacology of bisphosphonates and denosumab, and the risk of ARONJ.

Clinical relevance: What is the potential risk of ARONJ arising from dental treatment that we should be advising for our patients?

Author notes: Harlene Kaur Sidhu, BDS(Birm), MJDF(RCS, Eng), MSc Oral Surg(UCLAN), The University of Central Lancashire, Lancashire, UK.

Objective: To understand basic bone physiology and the difference in pharmacology of bisphosphonates and denosumab.