The influence of bisphosphonate therapy on orthodontic movement: a narrative review

Abstract

Objective: To carry out a narrative review on the influence of bisphosphonate use on orthodontic movement. Bibliographic review: Bisphosphonates are synthetic drugs similar to pyrophosphate. They are recommended for the control of pathologies that present a high bone resorption. These drugs accumulate in the superficial layer of bone tissue due to their binding by hydroxyapatite, mainly in areas of great bone resorption/remodeling. During bone remodeling, the drug is released at the site, starting its activity on osteoclasts, which reduces its action and cell formation, as well as induces the process of cell death. When osteoclasts arrive, it is known that this is the initial step necessary for the movement provided by orthodontics, and that any complication in the function of these cells will reduce the efficiency and outcome of orthodontic treatment. Final considerations: The use of bisphosphonates is not considered a complete contraindication for orthodontic treatment, especially for patients considered to be at low risk in relation to osteoporosis and neoplasms with bone metastases, however, the treatment outcome is still not predictable in patients with the osteoporosis and neoplasms with high-risk bone metastases.