4.2 Review

Osteonecrosis of the jaw related to the use of bisphosphonates

Journal

CURRENT OPINION IN ONCOLOGY
Volume 19, Issue 4, Pages 315-322

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/CCO.0b013e32819f820b

Keywords

bisphosphonates; jaw; osteonecrosis; osteonecrosis of the jaw

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Purpose of review Osteonecrosis of the jaw associated with the use of potent nitrogen containing bisphosphonates is a new and challenging clinical entity with a high impact on quality of life. This review attempts to consolidate the rapidly expanding literature into practical guidelines and provides expert consensus for areas of uncertainty. Recent findings Diagnostic criteria and a staging system for osteonecrosis of the jaw have been proposed, and histomorphologic analysis has confirmed osteonecrosis of the jaw as a proper disease, distinctively different from osteoradionecrosis. Various guidelines for the management of osteonecrosis of the jaw have been suggested and further retrospective research has provided new insights into its epidemiology. Summary Osteonecrosis of the jaw is a distinct entity of uncertain origin that, is increasingly being observed in patients treated with potent aminobisphosphonates, although the etiology is probably multifactorial. Recent data confirm the predisposition of multiple myeloma patients to develop osteonecrosis of the jaw. Although various treatment strategies have been reported, conservative management remains the mainstay of therapy.

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