Osteonecrosis of the jaw related to the use of bisphosphonates.
OBJECTIVE
Osteonecrosis of the jaw associated with the use of potent nitrogen containing bisphosphonates is a new and challenging clinical entity with a high impact on quality of life. This review attempts to consolidate the rapidly expanding literature into practical guidelines and provides expert consensus for areas of uncertainty.


RESULTS
Diagnostic criteria and a staging system for osteonecrosis of the jaw have been proposed, and histomorphologic analysis has confirmed osteonecrosis of the jaw as a proper disease, distinctively different from osteoradionecrosis. Various guidelines for the management of osteonecrosis of the jaw have been suggested and further retrospective research has provided new insights into its epidemiology.


CONCLUSIONS
Osteonecrosis of the jaw is a distinct entity of uncertain origin that is increasingly being observed in patients treated with potent aminobisphosphonates, although the etiology is probably multifactorial. Recent data confirm the predisposition of multiple myeloma patients to develop osteonecrosis of the jaw. Although various treatment strategies have been reported, conservative management remains the mainstay of therapy.
Van den Wyngaert
Tim
T
Department of Medical Oncology, Antwerp University Hospital, Belgium. tim.van.den.wyngaert@skynet.be
Huizing
Manon T
MT
Vermorken
Jan B
JB
D000890:Anti-Infective Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000009:adverse effects* / Q000494:pharmacology; D004164:Diphosphonates / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D007568:Jaw / Q000473:pathology*; D007571:Jaw Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D012307:Risk Factors
D000890:Anti-Infective Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates