Risedronate
Bisphosphonate (oral, antiresorptive)
Brand names: Actonel
Oral health effects
Medication-related osteonecrosis of the jaw (MRONJ)
Exposed necrotic jawbone failing to heal within 8 weeks in a patient on antiresorptive/antiangiogenic therapy without head/neck radiation. Low MRONJ risk in the osteoporosis setting; risk increases with treatment duration.
Mechanism: Suppressed bone turnover (and/or reduced angiogenesis) impairs healing and remodeling of the jaws after trauma or extraction.
Clinical management: Optimize oral health and complete invasive work before/early in therapy where possible; prefer non-surgical options and atraumatic technique; refer suspected MRONJ to oral surgery; coordinate with the prescriber.
Sources
- AAOMS Position Paper on Medication-Related Osteonecrosis of the Jaws: 2022 Update. Ruggiero SL, Dodson TB, et al.. Journal of Oral and Maxillofacial Surgery, 2022.