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Fixing dead jaw bones

February 4, 2009 3:16:34 PM PST
There is a new procedure to help osteoporosis patients and others who have intense jaw pain.That pain may be from osteonecrosis, which is dead bone in the jaw. It's been reported rarely in people taking drugs for weakened bones, drugs such as Fosamax and Actonel.

But drugs are just one risk factor. What's more, most current treatments do nothing to heal the bone. One surgeon has a new approach.

The new CAT scan machine can show problems with the jaw and teeth in great detail, and it's a good thing it was around for Marlen Garcia and Jennie Deming. Marlen was taking chemotherapy and Jennie a drug for osteoporosis. After some dental work, both began to have jaw pain.

"It was excruciating pain," Deming said. "I couldn't do anything, I couldn't sleep. It was unbearable pain."

That pain was the result of dead bone, called osteonecrosis, in Jennie's lower jaw. Her jaw bone was visible through her gum. Oral surgeon Dr. Ken Fleisher used a new method to get rid of the dead bone and allow new bone to grow back. After the CAT scan to diagnose the problem, patients first take tetracycline for two weeks. Once in the operating room, Dr. Fleisher exposes the problem bone and shines an ultraviolet light on it. Tetracycline sticks to bone and lights up under the purple light.

"Bone that doesn't take it too much in certain areas we remove," Dr. Fleisher said. "And bone that doesn't take it up at all, we remove because it's dead."

The healthy bone is left in place to re-grow.

A misconception is that drugs like Fosamax and chemotherapy drugs cause osteonecrosis or bone death. But the drugs do not cause it, they're just risk factors for osteonecrosis.

Other factors include diabetes, poor dental hygiene and chronic gum infections.

So how does Marlen feel now?

"Better," she said. "Totally better. No problem at all."

Dr. Fleisher emphasizes that people planning to begin chemotherapy or treatment for weakened bones have any dental infections and periodontal disease treated beforehand. He adds that if osteonecrosis occurs after treatment, that doctors speak to the patient's dentist first before stopping any medications.

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WEB PRODUCED BY: Bill King


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