The Influence of Bisphosphonates in the Oral Cavity in Children
Condition: Oral Cavity; Osteomyelitis; Necrosis of the Jaws
MeSH terms: Osteomyelitis; Necrosis
Study type: Observational

Summary: 
      The use of bisphosphonates during childhood to ameliorate the skeletal abnormalities
      associated with osteogenesis imperfecta, idiopathic juvenile osteoporosis, fibrous dysplasia
      of bone and cerebral palsy. There is paucity of long-term studies among children regarding
      the safety and efficacy of bisphosphonates.

      Osteomyelitis and necrosis of the jaws has been was discovered and reported as a serious
      adverse event in bisphosphonate-treated adults patients.

      To our knowledge, there is no report in the literature about osteomyelitis in children
      treated with bisphosphonates and the influence of long term treatment with bisphosphonates on
      children's jaws, the reaction to extractions and on the oral cavity.

      Aim of the study: to examine the influence in the oral cavity of bisphosphonate in children
    

Detailed description: 
      The use of bisphosphonates during childhood to ameliorate the skeletal abnormalities
      associated with osteogenesis imperfecta, idiopathic juvenile osteoporosis, fibrous dysplasia
      of bone and cerebral palsy. There is paucity of long-term studies among children regarding
      the safety and efficacy of bisphosphonates.

      Osteomyelitis and necrosis of the jaws has been was discovered and reported as a serious
      adverse event in bisphosphonate-treated adults patients.

      To our knowledge, there is no report in the literature about osteomyelitis in children
      treated with bisphosphonates and the influence of long term treatment with bisphosphonates on
      children's jaws, the reaction to extractions and on the oral cavity Aim of the study: to
      examine the influence in the oral cavity of bisphosphonate in children Materials and methods
      Population: 50 children treated with bisphosphonate will be included in the study.

      The following data will be recorded:

        1. age, gender, initial disease, age at diagnosis, additional diseases

        2. duration and dosage of the bisphosphonate medication (kind of bisphosphonate, age at the
           beginning of the drug treatment, duration of treatment, frequency of intake, additional
           medications)

        3. Clinical dental examination was performed for detection of; caries, gingival
           inflammation and oral hygiene, sequence of dental eruption, teeth extractions, and
           presence of exposure bone.

        4. Unstimulated whole saliva was collected using the spitting method as previously
           described. Sialochemistry analysis will be performed.

        5. Serum analysis findings including: calcium (Ca), phosphorous (P), alkaline phosphatase
           (AlP) and parathyroid hormone (PTH),vitamin D cross-linked telopeptides (ctx, ntx), bone
           density. (these examination are performed routinely, in these patients, as part of
           medical follow up.
    

Sampling method: Non-Probability Sample
Study population: 
        children treated with bisphosphonate who attend at the pediatric department of hadassah
        hospital and or to alyn hospital
      
Keywords: bisphosphonates; children; dental; Osteomyelitis; medication