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Paget's disease is a localized mono- or polyostotic progressive bone disease of possibly viral etiology characterized by increased bone remodeling, leading to pain, fractures, and skeletal deformities with the risk of osseous, articular and neurological complications. Appropriate treatment should be given to any patient with symptoms and any patient with a pagetic lesion in a high risk location, even if the patient is asymptomatic. First choice of treatment are now potent new bisphosphonates of second generation. These substances are captured in pagetic bone at high concentrations giving a continuing therapeutic effect after application has ceased. Monitoring the course of biochemical markers of bone turnover allows individual decisions about duration and frequency of treatment courses.

The ideal curative treatment of osteoporosis must be capable of raising the trabecular bone mass to its former level, since only a substantial increase in bone mass can reduce the fracture rate of the spine. Fluoride is an effective activator of osteoblasts and thus increases axial bone mass and decreases the vertebral fracture rate. The drawbacks of the formerly used sodium fluoride such as gastrolesivity and its in compatibility with concomitant calcium intake were overcome by using sodium monofluorophosphate (MFP) as the source of fluoride. MFP is well tolerated gastrointestinally and can be used concomitantly with calcium-containing medicaments or with calcium-rich alimentation. Fluoride treatment has proved to be an effective measure against continued progression of osteoporosis, and possible risks present no difficulties. The benefits of this therapy certainly outweigh possible adverse effects.