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- W3143262168 abstract "The Journal has published the Canadian Consensus Practice Guidelines for Bisphosphonate Associated Osteonecrosis of the Jaw1. The report gives recommendations of a multidisciplinary group of experts, endorsed by the Canadian Association of Oral Maxillofacial Surgeons and other groups, regarding diagnosis, prevention and therapy of osteonecrosis of the jawbones (ONJ) associated with bisphosphonates. The authors claimed the report provides a “rational evidence-based approach to the diagnosis, prevention, and management of bisphosphonate-associated ONJ,” and that their guidelines are based on the “best available published data and the opinion of national and international experts involved in the prevention and management of ONJ”1. We recognize the efforts of these authors in trying to clarify the controversial aspects of ONJ and provide clinical recommendations that could potentially reduce the risk of development of ONJ. However, we would highlight that some of the statements and recommendations presented are not based on best available evidence, the consequences upon clinical practice being potentially significant. 1. The authors state that “a link between ONJ and bisphosphonates has not yet been identified in the patient with osteoporosis in whom these agents are used in very low doses”. This statement should be read with caution, as potency and bioavailability of bisphosphonates, further to overall dosage, is well known to determine the risk of ONJ2. Moreover, the authors seem not to consider the hundred cases of ONJ reported in patients with osteoporosis and diseases other than cancer treated with oral bisphosphonates— it already being admitted in 2006 by Merck3 that the number of reported cases of ONJ associated with alendronate was … Address reprint requests to Prof. G. Campisi, Dipartimento di Scienze Stomatologiche, Settore di Medicina Orale, Università di Palermo, Via del Vespro 129, Palermo, Italy. E-mail: campisi{at}odonto.unipa.it" @default.
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- W3143262168 date "2009-02-01" @default.
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- W3143262168 title "To the Editor" @default.
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- W3143262168 doi "https://doi.org/10.3899/jrheum.080843" @default.
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