Navigating the Antiresorptive Frontier -"The Double-Edged Bone: Molecular Mechanisms of Antiresorptive Mechanisms in Dentistry- A Narrative Review

Author

Dr. B. LakshmanaRao, Dr. P. Ravi Teja, Dr. K. Vyshnavi, Dr. S. Namratha, Dr. K. Lakshmi Priyanka, Dr. G. Chinnari


Abstract

 Antiresorptive agents, mainly bisphosphonates and receptor activator of nuclear factor-κB ligand (RANKL) inhibitors, are commonly prescribed to reduce skeletal complications in metabolic and cancer-related bone diseases. These drugs help maintain bone mineral density, but their broad suppression of osteoclast-driven bone remodeling poses important challenges for dental and oral-maxillofacial care.

This review synthesizes the This review brings together the main pharmacological mechanisms of major antiresorptive classes, details their primary systemic and localized adverse effects—including medication-related osteonecrosis of the jaw (MRONJ), atypical femoral fractures (AFFs), and rebound hyper-remodeling—and evaluates their specific influence on peri-implant tissues and the pathogenesis of peri-implantitis.


Keywords

Antiresorptive Therapy, Dentistry / Oral Health, Double-Edged Bone, Molecular Mechanisms, Osteoclast Inhibition, Bone Turnover



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References


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