Current management concepts for bisphosphonate-related osteonecrosis of the jaw: a review

Bisphosphonate (BP) drugs are used to preserve bony tissue in patients diagnosed with osteoporosis and metastatic bone disease. However, these drugs are associated with rare but serious complications. The most commonly encountered adverse effect is bisphosphonate-related osteonecrosis of the jaw (BRONJ). Diagnosis and treatment of teeth that are likely to cause infection and the replacement or adjustment of dentures or restorations that could lead to trauma are the key steps that can be taken before the initiation of BP therapy in order to prevent the development of BRONJ. To date, the most efficacious management approach for BRONJ has not been clearly established. This article presents current approaches for the treatment of BRONJ, including conservative drug therapy and surgical therapy, and discusses new treatment modalities.