BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAW FOR THE HEALTH PROFESSIONAL: AN UPDATE MINIREVIEW

This article provides an overview of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and discusses its historical background, the biology of bisphosphonates, defines BRONJ, reports its prevalence in both oral and intravenous (IV) settings, risk factors, preferential sites, staging, strategies for prevention and management, and touches on new anti-resorptive drugs.

To be diagnosed with BRONJ, a patient must be on current (or previous) treatment with a bisphosphonate, must have signs of exposed bone in the maxillofacial facial region that has persisted for more than eight weeks, and must have no history of radiation therapy to the jaws. The prevalence for oral dosage is estimated at 1:1700, and between 1:10 to 1:100 for IV dosage, with the mandible being affected in 65% of cases.

The exact causal link of bisphosphonate therapy and osteonecrosis is still not fully understood. Patients undergoing IV bisphosphonate therapy are at greater risk than those undergoing oral therapy, although the risk should not be underestimated.