Updates on osteonecrosis of the jaw.
OBJECTIVE
Osteonecrosis of the jaw (ONJ) is an uncommon condition noted to occur in patients with cancer who are receiving intravenous bisphosphonates. The cause of ONJ remains unknown. The leading hypotheses addressing the mechanism of ONJ are reviewed here.


RESULTS
The present clinical data suggest that ONJ may occur in approximately 5% of patients with metastatic bone disease. The ability to predict an individual's risk of developing ONJ remains elusive. It is likely that an altered bone microenvironment and/or host defense mechanisms effected by medications used to treat patients with metastatic bone disease contributes to the development of ONJ. Medications that significantly reduce osteoclastic activity are associated with ONJ. Preclinical models of ONJ are being developed but to establish such an intricate systemic condition in animals is challenging.


CONCLUSIONS
The ONJ field has progressed via knowledge gained by case reports, population-based studies, and emerging animal models. Still, there are myths that need to be resolved and important clues that need to be investigated. Understanding the pathophysiology of this condition will be critical to improve patient care. Communications between oncologists, dentists, basic scientists, and patients are central to effective treatment and research for this condition.
Yamashita
Junro
J
Department of Biologic Materials and Sciences, University of Michigan, Ann Arbor, Michigan 48109, USA.
McCauley
Laurie K
LK
Van Poznak
Catherine
C
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007568:Jaw / Q000473:pathology*; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010020:Osteonecrosis / Q000188:drug therapy* / Q000209:etiology; D012307:Risk Factors; D000077211:Zoledronic Acid
D020533:Angiogenesis Inhibitors; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid