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Osteonecrosis of the Jaws and Bisphosphonate Therapy

¹ Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Long Island Jewish Medical Center, Division of Oral and Maxillofacial Surgery, New Hyde Park, NY; and
² New York Center for Orthognathic and Maxillofacial Surgery, 2001 Marcus Ave., Suite N10, Lake Success, NY 11042, USA

^* corresponding author, sruggie{at}optonline.net

Bisphosphonates are a class of agents used to treat osteoporosis and malignant bone metastases. The efficacy of these agents in treating and preventing the significant skeletal complications associated with these conditions has had a major positive impact for patients and is responsible for their widespread use in medicine. Despite these benefits, osteonecrosis of the jaws has recently emerged as a significant complication in a subset of patients receiving these drugs. Based on a growing number of case reports and institutional reviews, bisphosphonate therapy may cause exposed and necrotic bone that is isolated to the jaw. This complication usually presents following simple dento-alveolar surgery, and can cause a significant adverse effect on the quality of life for most patients. The pathogenesis for this complication appears to be related to the profound inhibition of osteoclast function and bone remodeling.

KEY WORDS: bone • bisphosphonate • BRONJ • mandible • osteonecrosis • osteoporosis • jaw

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