Bisphosphonate Induced Osteonecrosis Of Jaws

Bisphosphonates are drugs which are used for the treatment of osteoporosis, Hypercalcemia of malignancy, skeletal-related symptoms, Multiple Myeloma, Metastatic bone lesions of solid tumor cancers such as Breast, Prostate and Lung cancer. An important characteristic of these drugs is their highly selective localization and retention in bone compared to other tissues. Bisphosphonates work by reducing bone turnover, increasing bone mass, and decreasing the risk of fracture. In recent years it has been noted that a small subset of patients (1-10%) treated with intravenous Bisphosphonates are at an increased risk of developing osteonecrosis of the jaw (BPONJ). Osteonecrosis is defined as an area of exposed bone in the maxillofacial region that does not heal within 8 weeks in a patient who is currently receiving bisphosphonate medication and has not had radiation to the head-neck region. The publicity surrounding this complication and the lack of information about its underlying pathogenesis has led to apprehension amongst patients and dental clinicians when treating patients with a history of Bisphosphonate Therapy.