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"Bisfosfonat: tinjauan singkat pengembangan penggunaanya di bidang kedokteran gigi. Obat ini menghambat resorpsi tulang dengan memicu osteoklas mengalami apoptosis. Bisfosfonat (BP) memiliki potensi manfaat besar dalam dunia kedokteran gigi mengingat bahwa baik penyakit maupun prosedur perawatan gigi dapat menyebabkan ketidakstabilan gigi dan diketahui bahwa tulang alveolar merupakan jaringan pendukung utama gigi. Indikasi kuat dari obat ini adalah untuk mencegah dan meminimalkan resorpsi tulang setelah operasi bedah mulut dan gerakan relaps setelah perawatan ortodontik. Penggunaan secara klinis BP dalam kedokteran gigi dibatasi oleh risiko osteonekrosis rahang (ONJ) dan efek sistemik seperti peningkatan kepadatan mineral tulang di daerah lain. Aplikasi topikal dengan efek lokal tampak sebagai pilihan solusi untuk risiko di atas. Penelitian terbaru dari BP topikal belum sampai pada penggunaan klinis, tetapi dari beberapa penelitian pada hewan coba telah memberikan bukti bahwa obat ini akan bermanfaat dalam lingkup yang luas pada perawatan kedokteran gigi.

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Bisphosphonate (BP) is a class of drug that prevent the loss of bone mass. It inhibits the resorption of bone by encouraging osteoclast to undergo apoptosis. Considering that oral diseases and dental procedures may lead to teeth instability whereas alveolar bone is the main tooth supporting tissue, forceful indication of this drug is for preventing and minimizing bone resorption following oral surgery and relapse movement in orthodontic treatment. Clinical use of BP in dentistry is limited by risk of osteonecrosis of the jaw (ONJ) and of itssystemic effects such as an increase of the bone mineral density in another bone area. Topical application with local effect would seem the choice of administration route for usage in dentistry. Until recently, no clinical usage of topical BP has been studied, however some experimental laboratory studies proved that this drug would be beneficial in a wide scope of dental treatments."

"During the early 19th century, it was discovered that adding yellow (now called white) phosphorous to matchstick heads made it easier to ignite matches. The phosphorous vapors were breathed in by workers and combined with other chemicals in the body to produce a potent nitrogen-containing bisphosphonate. Today's oral nitrogen-containing bisphosphonates and intravenous nitrogen-containing bisphosphonates circulate around the body the same way as the phosphorous vapors, and are absorbed into bone and ingested by osteoclasts. When this unique binding process of bisphosphonates to bone occurs, osteoclasts are poisoned, and this reduces or eliminates bone turnover. Alveolar bone in the mandible and maxilla turns over more rapidly than in long bones, so the jaws are a better target for bisphosphonate toxicity. It wasn't until 2003 that today's intravenous and oral nitrogen-containing bisphosphonate medications were implicated as major risk factors in the development of exposed necrotic bone of the jaws. Most of the researchers who reported cases of bisphosphonate-induced osteonecrosis of the jaw found that these patients were treated with zoledronate, pamidronate, or a combination of these drugs, which are commonly used for treating breast cancer or myeloma. In about 5% of cases, subjects with BIONJ were being treated for osteoporosis. Precipitating events that contribute to BIONJ are tooth extractions (about 50% of cases), mandibular exostoses, periodontal disease, and local trauma from ill-fitting dentures. It is not known if the placement of dental implants is a precipitating factor. The book aims to meet the need of medical practitioners working in all fields that use bisphosphonates, and to present the conservative and surgical treatment methods currently in use. There will also be detailed information on the literature relating to dental implants in patients treated with bisphosphonates."