title: Bisphosphonate-Related Osteonecrosis of the Jaws and Its Array of Manifestations.
abstract: OBJECTIVE
  Bisphosphonate (BP) therapy in the treatment of bone diseases and malignancy may induce a major side effect known as bisphosphonate-related osteonecrosis of the jaws (BRONJ). A particular view of this condition is reported in this case series investigating eight patients. The aim of the study was to evaluate the BRONJ lesions concerning their aspects and progression. Also, identify if it is possible to predict the degree of severity in these cases.
  
  
  METHODS
  Patients were evaluated by their condition and systemic health. The lesions were evaluated in clinical and radiographic aspects. The patients were followed-up for 2 years.
  
  
  RESULTS
  The patients presented with specific peculiarities, and the BRONJ lesions varied in several characteristics. The BRONJ lesions ranged from simple to severe conditions, and the complicated cases presented with major pain, swelling, secondary infection and an extensive necrotic area, classified with high grade of severity.
  
  
  CONCLUSIONS
  The patients presented here confirm the existence of a relation between multiple features and BRONJ and to understand the whole process of aggravation, all systemic and local information have to be taken into account, together with all data related to the BP utilized. Regardless of the low incidence of this side effect in relation to osteoporosis treatment, in some cases, the BRONJ may become a severe condition and compromise the patient's quality of life.
authors.affiliation: UFR de Médecine Lyon-Est Domaine Laennec, INSERM UMR 1033, Université de Lyon, 7-11 Rue Guillaume Paradin, 69372 Lyon Cedex 08, France ; Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil ; A. C. Camargo Cancer Center, Fundação Antonio Prudente, Rua Professor Antônio Prudente 211, São Paulo, 01509-900 Brazil.
authors.forename: Gustavo Davi
authors.initials: GD
authors.lastname: Rabelo
authors.affiliation: Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil ; Santos Metropolitan University, Rua da Constituição 374, Vila Nova, Santos, 11015-470 Brazil.
authors.forename: José Narciso Rosa
authors.initials: JN
authors.lastname: Assunção
authors.affiliation: UFR de Médecine Lyon-Est Domaine Laennec, INSERM UMR 1033, Université de Lyon, 7-11 Rue Guillaume Paradin, 69372 Lyon Cedex 08, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Chavassieux
authors.affiliation: Santos Metropolitan University, Rua da Constituição 374, Vila Nova, Santos, 11015-470 Brazil.
authors.forename: Haroldo Arid
authors.initials: HA
authors.lastname: Soares
authors.affiliation: Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil ; A. C. Camargo Cancer Center, Fundação Antonio Prudente, Rua Professor Antônio Prudente 211, São Paulo, 01509-900 Brazil.
authors.forename: Fabio Abreu
authors.initials: FA
authors.lastname: Alves
authors.affiliation: Department of Stomatology, Faculty of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitária, São Paulo, CEP 05508-000 Brazil.
authors.forename: Celso Augusto
authors.initials: CA
authors.lastname: Lemos
keywords: Bisphosphonate; Cancer; Jaws; Osteonecrosis; Osteoporosis