Orthodontic treatment of patients using bisphosphonates: A report of 2 cases

The pharmacologic agent bisphosphonate has recently received much attention in the dental literature. Bisphosphonates in oral or intravenous forms are used to treat various diseases such as certain cancers, bone- and calcium-related disorders, osteoporosis, and osteopenia. Bisphosphonates inhibit bone turnover and result in increased bone-mineral density. The most serious dental side effect of bisphosphonate treatment (particularly when it is administered intravenously) is, paradoxically, osteonecrosis of the mandible or the maxilla represented by exposed nonhealing bone. Other related complications include decreased bone healing and inhibition of orthodontic tooth movement. This article reports the orthodontic treatment of 2 patients who were taking bisphosphonates.