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Bisphosphonate-related osteonecrosis of the jaws

Kushner, George M.; Alpert, Brian

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2011 - Volume 19 - Issue 4 - p 302–306
doi: 10.1097/MOO.0b013e328348b257
Maxillofacial surgery: Edited by Sherard A. Tatum

Purpose of review The purpose of this article is to review a new pathologic entity named bisphosphonate-related osteonecrosis of the jaws (BRONJ).

Recent findings BRONJ was observed and first reported in 2001–2002 when clinicians noticed cases of refractory osteomyelitis after simple dental procedures such as dental extractions in patients who had received bisphosphonate therapy. The condition was initially seen in patients who received i.v. bisphosphonates for malignancies such as multiple myeloma and metastatic breast cancer. However, with the use of bisphosphonate therapy for osteoporosis, BRONJ is seen in patients without a cancer diagnosis.

Summary The incidence of BRONJ remains unclear. Treatment recommendations based on sound scientific data are sparse. The management of BRONJ remains a difficult and controversial situation that continues to challenge the clinician.

University of Louisville, Louisville, Kentucky, USA

Correspondence to George M. Kushner, DMD, MD, Professor of Oral and Maxillofacial Surgery, University of Louisville School of Dentistry, 501 S. Preston St, Louisville, KY 40202, USATel: +1 502 852 5083; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.