Oral Bisphosphonate-Related Osteonecrosis of the Jaw: Incidence, Clinical Features, Prevention, and Treatment Recommendations

Biphosphonate-related osteonecrosis of the jaw (BRONJ) is a devastating side effect of oral bisphosphonates associated with patient morbidity and high financial burden to health services. BRONJ is usually associated with parenteral use of bisphosphonates in oncologic patients, but its incidence among individuals with osteoporosis who take oral bisphosphonates is on the rise. In the absence of definitive treatment for BRONJ, every effort should be made toward its prevention. The patients must be informed about the extremely small but proven risk of oral BRONJ and be recommended to undergo periodic dental evaluation and meticulous oral hygiene. Once BRONJ occurs, long-term antibiotic therapy and superficial curettage may be beneficial.