PatientFYI: Bisphosphonates, (also known as disphosphonates) are a class of drugs that prevent the loss of bone mass, used for treatment ranging from osteoporosis to cancer related conditions. Bisphosphonate has become a prevalent drug in our society and is a potent suppressor of osteoclastic (bone resorbing) activities, thus bone remodeling and healing are being affected.To clarify, bone has constant turnover, and is kept in balance (homeostasis) by “osteoblasts” which are responsible for creating bone and “osteoclasts” which digest bone. Bisphosphonate inhibits osteoclastic activities in bone, in other words, it inhibits the digestion of bone by osteoclasts. Surgeons are often faced with the dreaded possibility of bisphosphonate related osteonecrosis (bone death) of the jaw with patients who have been taking this class of medication, as the possibility of a successful outcome reduces.

Due to recent developments we now use a serum C-terminal telopeptide (CTX) test as a guide to predict the outcome of our reconstructive surgery. This helps us select the appropriate patient for surgery and increases the rate of a successful surgical outcome.