112. Bisphosphonate-Associated Osteonecrosis of the Jaws

  1. Clifford J. Rosen MD
  1. Hani H. Mawardi,
  2. Nathaniel S. Treister and
  3. Sook-Bin Woo

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch112

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Mawardi, H. H., Treister, N. S. and Woo, S.-B. (2013) Bisphosphonate-Associated Osteonecrosis of the Jaws, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch112

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • bisphosphonate-associated osteonecrosis (BONJ);
  • jaws;
  • osteolysis;
  • osteosclerosis;
  • zoledronic acid

Summary

Of the several cases of bisphosphonate-associated osteonecrosis of the jaws (BONJ), the vast majority are in patients with multiple myeloma and metastatic cancers to the skeletal system who were treated with intravenous bisphosphonates. This chapter talks about, inter alia, etiology, risk factors, clinical presentation, radio graphic findings, and management of BONJ. The etiopathogenesis has been attributed primarily to suppression of bone turnover coupled with conditions that are unique to the mandible and maxilla. One of the most consistently observed risk factors is the use of nitrogen-containing bisphosphonates and in particular zoledronic acid, which is the drug of choice for treating multiple myeloma and metastatic cancers in the U.S. BONJ presents with exposed, yellowish-white necrotic bone, where lesions are more common in areas with very thin mucosa overlying bony prominences. A number of radiographic signs have been identified in BONJ, including osteosclerosis and osteolysis.