title: Bisphosphonate-related osteonecrosis of the jaws--a review.
abstract: The aim was to evaluate the knowledge about bisphosphonate-related osteonecrosis of the jaws (BRONJ). A bibliographic search in Medline, PubMed and the Cochrane Register of controlled clinical trials was performed between 2003 and 2010 by using the terms bisphosphonate and osteonecrosis of the jaw. The amount of publications per year, the type of journal for publication, and the evidence level of the trial were evaluated. Next to this the incidences and the success of treatment strategies for BRONJ were identified. A total of 671 publications were reviewed. Since 2006 more than 100 publications on BRONJ per year (with an upward trend) have been published, mostly in dental journals. The evidence level could be determined for 176 publications and only one grade Ia study was found. The studies showed a wide variety in design, most of them being retrospective. The incidence of BRONJ is strongly dependent on oral or intravenous application and varies between 0.0% and 27.5%. There is no scientific data to sufficiently support any specific treatment protocol for the management of BRONJ. Further clinical studies are needed to evaluate the incidence and treatment strategies at a higher level of evidence. Therefore uniform study protocols would be favourable.
authors.affiliation: School of Dental Medicine, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland. Electronic address: Sebastian.kuehl@unibas.ch.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kühl
authors.affiliation: University Medical Center Mainz, Department of Oral and Maxillofacial Surgery, Augustusplatz 2, 55131 Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Walter
authors.affiliation: School of Dental Medicine, Department of Oral Surgery, Oral Radiology, University of Graz, Auenbruggerplatz 12, 8036 Graz, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Acham
authors.affiliation: School of Dental Medicine, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Pfeffer
authors.affiliation: School of Dental Medicine, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland.
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Lambrecht
mesh_terms: D000284:Administration, Oral; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000453:epidemiology / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001847:Bone Diseases / Q000188:drug therapy; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007275:Injections, Intravenous; D010506:Periodicals as Topic / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates