Bisphosphonate-related osteonecrosis of the jaws: a comprehensive review.
BACKGROUND
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) presents the clinician with significant management dilemmas. The purpose of this study was to distil information related to this disorder by comprehensively reviewing the literature.


METHODS
The structure and function of bisphosphonates, and their role in the development of BRONJ will be discussed, as will the possible mechanisms through which this pathology develops. A review of cases presented in the literature will be undertaken, and suggestions offered as to the management of this pathology in terms of surgical and conservative approaches.


RESULTS
Presentation of BRONJ is currently more common in patients taking intravenous forms of bisphosphonates, but there is a fear that the long-term cumulative effects of oral bisphosphonates may see BRONJ increasingly occurring in this patient group.


CONCLUSIONS
Prevention is superior to treatment, and the establishment of meticulous oral hygiene and pre-emptive surgical treatment prior to commencement of bisphosphonate therapy is recommended.
Hewitt
Catherine
C
Oral Medicine and Pathology, School of Dentistry, The University of Queensland, Brisbane, Australia.
Farah
Camile S
CS
D000818:Animals; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000628:therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000628:therapy; D013997:Time Factors
D050071:Bone Density Conservation Agents; D004164:Diphosphonates