Bisphosphonate-related Osteonecrosis of the Jaw (BRONJ) is a condition which, according to the American Association of Oral and Maxillofacial Surgeons (AAOMS), adversely affects between .8-12percent of the population, a small yet significant amount of adults. Osteonecrosis of the Jaw (ONJ) is characterized by the death of bone and suffering patients present with either a non-healing extraction socket or an exposed jawbone. In general, afflicted patients have been treated with a class of drugs known as the Bisphosphonates (BP). Bisphosphonates were originally developed in order to treat and manage many metastatic diseases of the bone and stabilize bone loss caused by osteoporosis. Recently, oral surgeons have seen many patients with necrotic lesions on the jaw. The common theme between these patients was that they had all received chronic bisphosphonate therapy. This paper will attempt to review current medical literature on this most important topic. To facilitate this, the paper will first delve into the histology and physiology of the bone. Once that is understood, the history of the BP’s will be traced: 1) Why they were developed, 2) their early chemical structures, 3) how they 43 evolved, and 4) what are the current recommendations for patients who are suffering. Reduction of bone vascularity and of the normal remodeling of the bone, and the accumulation of microdamaged bone, both causes of necrotic lesions to the jaw bone, will be explained and various case studies will be discussed with regard to their diagnoses and treatment/management plans of BRONJ.
Leah Katz, C. (2009). Bisphosphonates and Osteonecrosis of the Jaw. The Science Journal of the Lander College of Arts and Sciences, 2(1), 43-52. Retrieved from https://touroscholar.touro.edu/sjlcas/vol2/iss1/5