Denosumab: a drug against osteoporosis can complicate dental treatments

Abstract

Introduction: In 2010, the clinical use of Denosumab for osteopororis´ treatment was approved in the EEUU. Even though a lot of people think that it is a bisphosphonate, actually it is a monoclonal antibody that inhibits RANKL. Hypothesis and objectives: The hypothesis of this article is that osteonecrosis of the jaw (ONJ) is an adverse effect of Denosumab. Material and method: Bibliographic review from the data base Pubmed and the virtual library of the UCM. Discussion and results: Denosumab, as an antiresorptive drug, gets its importance in the etiology of ONJ because of the excessive suppression of bone remodeling. In patients under treatment of this drug, we have to pay attention to the interval between the doses and the accumulative dose in order to evaluate the risk of developing it. The AAOMS suggests a multidisciplinary approach where the dentist assumes an important role, especially in prevention. Conclusions: We have to stop considering that the ONJ is only caused by bisphosphonates because other drugs such as Denosumab can also cause it. We should take preventative measures with this possibility.