Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment

Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The ai...

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Main Authors: Lars Rasmusson, Jahan Abtahi
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2014/471035
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author Lars Rasmusson
Jahan Abtahi
author_facet Lars Rasmusson
Jahan Abtahi
author_sort Lars Rasmusson
collection DOAJ
description Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly.
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spelling doaj-art-67c8ffe19f2346e89ecd8fbf7ac8071b2025-08-20T02:24:01ZengWileyInternational Journal of Dentistry1687-87281687-87362014-01-01201410.1155/2014/471035471035Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and TreatmentLars Rasmusson0Jahan Abtahi1Department Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 405 30 Gothenburg, SwedenMaxillofacial Unit, Linköping University Hospital, 581 85 Linköping, SwedenOsteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly.http://dx.doi.org/10.1155/2014/471035
spellingShingle Lars Rasmusson
Jahan Abtahi
Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment
International Journal of Dentistry
title Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment
title_full Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment
title_fullStr Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment
title_full_unstemmed Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment
title_short Bisphosphonate Associated Osteonecrosis of the Jaw: An Update on Pathophysiology, Risk Factors, and Treatment
title_sort bisphosphonate associated osteonecrosis of the jaw an update on pathophysiology risk factors and treatment
url http://dx.doi.org/10.1155/2014/471035
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