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An advisory statement from the American Dental Association Council on Scientific Affairs

Background and Overview. In 2005, the American Dental Association (ADA) Council on Scientific Affairs convened an expert panel to develop clinical recommendations for dentists treating patients who are receiving oral bisphosphonate therapy. The Journal of the American Dental Association published the resulting report in 2006. This 2008 advisory statement is the first of projected periodic updates of the 2006 clinical recommendations.

Conclusion. This 2008 advisory statement concludes, on the basis of a review of the current literature, that for patients receiving bisphosphonate therapy, the risk of developing bisphosphonate-associated osteonecrosis (BON) of the jaw apparently remains low. It also newly concludes that current screening and diagnostic tests are unreliable for predicting a patient’s risk of developing the condition. This statement updates the 2006 recommendations regarding general dentistry, management of periodontal diseases, implant placement and maintenance, oral and maxillofacial surgery, endodontics, restorative dentistry and prosthodontics, and orthodontics.

Key Words: Bisphosphonate-associated osteonecrosis; osteoporosis; osteonecrosis

Abbreviations: ADA: American Dental Association. • BON: Bisphosphonate-associated osteonecrosis. • CTX: C-terminal cross-linking telopeptide of Type I collagen. • NTX: N-telopeptide of Type I collagen.

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