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Osteoporosis: The Oral-Systemic Connection

Robert E. Marx, DDS
Saturday, February 8
2:00 pm - 2:45 pm

Osteoporosis is an age- and hormone-related thinning of the cancellous trabeculae and cortex, which structurally weakens bone at varying degrees and thus makes it more prone to fracture. Osteoporosis involving the jaws causes a thinning of their bony trabeculae and cortex, just as it does in other bones; this is often referred to as type III or type IV bone. It is much more difficult to gain primary stability during implant placement, and there is reduced osseointegration potential. However, the greatest impact of osteoporosis on the jaws is a condition now known as drug-induced osteonecrosis of the jaws (DIONJ). All oral and intravenous bisphosphonates marketed for osteoporosis, as well as oral denosumab, have caused DIONJ. Yet, alendronate (Fosamax) because of its potency and a recommended dose that is twice that of other oral bisphosphonates, has been responsible for more than 90% of all reported cases and has even caused femur fractures. It is the osteoporosis drug of greatest oral impact.