Bisphosphonates-related osteonecrosis of the jaws: a concise review of the literature and a report of a single-centre experience with 151 patients

J Oral Pathol Med. 2012 Mar;41(3):214-21. doi: 10.1111/j.1600-0714.2011.01091.x. Epub 2011 Sep 30.

Abstract

The osteonecrosis of the jaws (ONJ) is an adverse side effect of long-term bisphosphonate therapy (BPT) firstly described in 2003. The aetiology of BRONJ remains unknown, and the pathogenesis seems multifactorial and related to several local or general factors. Many expert panel developed preventive protocols to facilitate specialists involved in the multidisciplinary management of BRONJ patients. In this paper, we present a concise review of the literature, and we report the experience of the University of Parma with 151 patients that assumed BPT for both oncological (121 patients) and non-oncological (30 patients) diseases. One hundred and thirty-nine BRONJ sites were treated with different approaches (surgical and non-surgical, laser-assisted and non-laser-assisted): in terms of clinical improvement, a statistically significant difference was found between the group treated with the only medical therapy; in terms of complete healing, the introduction in the treatment protocols of both laser-assisted approach and surgical approach improves the therapeutical results.

Publication types

  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local / therapeutic use
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / therapy*
  • Bone Density Conservation Agents / administration & dosage
  • Bone Neoplasms / drug therapy
  • Curettage
  • Debridement
  • Diphosphonates / administration & dosage
  • Female
  • Humans
  • Laser Therapy / methods
  • Low-Level Light Therapy / methods
  • Male
  • Multiple Myeloma / drug therapy
  • Oral Surgical Procedures
  • Osteoporosis / drug therapy
  • Tooth Extraction
  • Wound Healing / physiology

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Bone Density Conservation Agents
  • Diphosphonates