title: Bisphosphonate-related osteonecrosis of the jaw: specificities.
abstract: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe complication that has recently emerged in patients treated with intravenous bisphosphonates for malignant diseases. This complication usually presents after a minor local trauma during a dental treatment. Several etiopathogenic mechanisms of this pathological condition have been proposed, but no model can explain all morphological changes observed at the macroscopic and microscopic level. BRONJ is likely to be related to direct toxicity in the bone and soft tissue cells, due to nitrogen-containing bisphosphonates. This review elucidates the clinical indications and mechanism of action of bisphosphonates, reports some clinical diagnostic criteria for BRONJ, describe the histopathological criteria for BRONJ diagnosis, the potential triggering pathways and the available treatment strategies.
authors.affiliation: Faculty of Medicine, Coimbra University , Portugal.
authors.forename: Siri
authors.initials: S
authors.lastname: Paulo
authors.affiliation: Faculty of Medicine, Coimbra University , Portugal.
authors.forename: Ana Margarida
authors.initials: AM
authors.lastname: Abrantes
authors.affiliation: Faculty of Medicine, Coimbra University , Portugal.
authors.forename: Mafalda
authors.initials: M
authors.lastname: Laranjo
authors.affiliation: Faculty of Medicine, Coimbra University , Portugal.
authors.forename: Lina
authors.initials: L
authors.lastname: Carvalho
authors.affiliation: Faculty of Science and Technology, Coimbra University , Portugal.
authors.forename: Arménio
authors.initials: A
authors.lastname: Serra
authors.affiliation: Faculty of Medicine, Coimbra University , Portugal.
authors.forename: Maria Filomena
authors.initials: MF
authors.lastname: Botelho
authors.affiliation: Faculty of Medicine, Coimbra University , Portugal.
authors.forename: Manuel Marques
authors.initials: MM
authors.lastname: Ferreira
keywords: bisphosphonate; bone; jaw; osteonecrosis; soft tissues