Bisphosphonate-related osteonecrosis of the jaws: a call for multidisciplinary approaches

Bisphosphonates have been prescribed for the treatments of oncologic and metabolic bone diseases to inhibit bone resorption of osteoclasts. However, in recent years, the increased numbers of cases diagnosed with exposed and necrotic bone localized in the jawbones associated with bisphosphonate use have been reported, mostly in patients with multiple myeloma or bone metastases who received long-term intravenous bisphosphonate treatments. The strong association between patients receiving dentoalveolar surgery and the incidence of this complication highlights the need for multidisciplinary approaches and necessitates the close attention from a team of health care personnel. The present review summarizes the current knowledge on etiology, risk factors, clinical presentations, and recommended preventive measures and managements for afflicted patients. In light of recent available data and because stanterdized management strategies have not been well established, prevention seems to be of paramount benefit to this group of patients.