A perspective on bisphosphonate-related osteonecrosis of the jaw

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  • IKEBE Tetsuro
    Section of Oral Surgery, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College
  • OZEKI Satoru
    Section of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College

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  • ビスホスホネート系薬剤関連顎骨壊死の現状と対策

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An increasing number of cases for bisphosphonate-related osteonecrosis of the jaw (BRONJ) have been reported since the first publication regarding it in 2003. Bisphosphonate, a drug to inhibit osteoclast activity, is administered intravenously or orally to the patients suffering from multiple myeloma, cancer bone metastasis and osteoporosis in order to treat the pathological bone resorption. In BRONJ, however, this drug is thought to impair bone turnover and angiogenesis of the jaw, leading to bone necrosis as an adverse side effect. Bone necrosis is occasionally triggered by dental surgery such as tooth extraction, promoted by bacterial infection, and exposed out of gingiva. The incidence of BRONJ in the patients taking oral bisphosphonate is very rare, but there have been considerable numbers of BRONJ occurring. Because the population of osteoporosis patients taking oral bisphosphonate increases year after year, dentists and oral surgeons must be careful at treating such patients for BRONJ. In this review, the recent findings, concepts and management for BRONJ are presented. The occurrence of BRONJ seems to clarify the critical role, osteoclasts play in the bioregulation mechanism of the jaw.

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