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Re: Bisphosphonates and osteonecrosis - from an OMFSFrom: Kim Elise Goldman (goldman@calweb.com)Sun Jun 4 16:25:09 2006
I am very appreciative of all your kind comments and hope the material is helpful to you. I must admit I am more than a bit apprehensive about someone printing this out as if it is holy writ and handing it out to their patients. I have no problem with it being shared with other professionals. I am hoping that I incorrectly construed your "passing around the clinic" comment to include patients. This is one doctor's personal opinion based on my clinical experience and review of the literature. It is the way *I* have chosen to handle answering these questions in my practice and, as a small, thin, 50 year old female, for myself personally. Other OMFS may take different approaches. Unfortunately, in this overly litigious society there are some who might interpret a written document with my name on it as making me a "treating" or officially consulting doctor on your patients and therein lies my discomfort at the idea of this being "passed out in the clinic". Here are two of the landmark published references which you may want to share with your patients and colleagues. 1. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL Journal of Oral and Maxillofacial Surgery May 2004 (Vol. 62, Issue 5, Pages 527-534) Abstract | Full Text | PDF (235 KB) 2. Bisphosphonate-Induced Exposed Bone (Osteonecrosis/ Osteopetrosis) of the Jaws: Risk Factors, Recognition, Prevention, and Treatment Marx RE, Sawatari Y, Fortin M, Broumand V Journal of Oral and Maxillofacial Surgery November 2005 (Vol. 63, Issue 11, Pages 1567-1575) Abstract | Full Text | PDF (358 KB) You can download the abstracts at http://www.joms.org or through Medline. I review for all three of our journals ((American) Journal of Oral & Maxillofacial Surgery, International Journal of Oral & Maxillofacial Surgery, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology & Endodontology) and I am on the editorial board for OOO as well. All of these journals are receiving multiple new submissions on this subject and frequent Medline checks may be helpful in assisting everyone to stay as up to date as possible with our state of knowledge about this problem. One day, I hope, I will have good reason to change my current philosophy, either because we have discovered how to prevent or treat this problem or because we have discovered other medications which will treat the bone disease without the rare but extremely morbid side effect we are discussing here. Stepping quietly off my soapbox now and again, thanking one and all for the courteous reception here and the open dialogue. Together, we can hopefully find a pathway for all of our patients. Kim On Jun 4, 2006, at 4:47 PM, ginny lee, CNM wrote:
> At Sun, 4 Jun 2006, Garry E. Siegel, M.D. wrote:
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