Bisphosphonates and osteonecrosis of the jaws

Abstract

Bisphosphonates are important drugs that are increasingly prescribed to reduce the morbidity associated with osteoclast-mediated bone diseases. Shortly after the turn of the century, a variety of case reports described a necrosis of the jaw bone in patients using bisphosphonates. Currently, an exposed area of necrotic jaw bone present for at least eight weeks in patients using bisphosphonates has been defined as a bisphosphonate-associated osteonecrosis (BON) by the American Dental Association. BON may occur spontaneously but is more frequently associated with local trauma to the jaw. At this time, a causal relationship between BON and bisphosphonates has not been demonstrated. This review will evaluate current data related to the occurrence, risk, prevention, treatment, and management of BON.