An Update on Bisphosphonate-related Osteonecrosis of the Jaw.
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Date
2013-08
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Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a condition found in patients who have received intravenous
and oral forms of bisphosphonate therapy for various bone-related conditions. BRONJ, manifests as exposed, nonvital bone
involving the maxillofacial structures. The mandible is more commonly affected than the maxilla (2:1), and 60% of cases are
preceded by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinically evident
osteonecrosis include changes in the health of periodontal tissues, nonhealing mucosal ulcers, loose teeth and unexplained
soft-tissue infection. Although, the definitive role of bisphosphonates remains to be elucidated, alteration in bone metabolism
with surgical insult or prosthetic trauma appears to be key factors in the development of BRONJ. The significant benefits
that bisphosphonates offer to patients clearly outbalance the risk of potential side effects; however, any patient for whom
prolonged bisphosphonate therapy is indicated, should be provided with preventive dental care in order to minimize the risk
of developing this severe condition. This article provides a review of current developments about the pathogenetic, clinical,
management and preventive aspects of BRONJ.
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Keywords
Bisphosphonates, osteonecrosis of jaw, bisphosphonate related osteonecrosis of jaw
Citation
Kurien Jacob, Sunil E Anuradha, Mukunda Archana, Philip Sunitha Raj. An Update on Bisphosphonate-related Osteonecrosis of the Jaw. Indian Journal of Clinical Practice. 2013 Aug; 24(3): 267-270.