Interdisciplinary Management of Bisphosphonate-Related Osteonecrosis of the Jaw

Abstract

Bisphosphonate (BP) Related Osteonecrosis of the Jaw (BRONJ) is one of the frequently occurring adverse reaction of BP intake, which is indicated in management of osteoporosis, Paget disease, multiple myeloma, and hypercalcemia in malignancies. The risk of osteonecrosis of the jaw relates to dose and duration of the therapy and the route of administration (i.e. more often BRONJ occurs in patients undergoing intravenous BPs therapy). At present, the management of BRONJ is a dilemma. No effective treatment has yet been developed. There is currently no gold standard of treatment for BRONJ. However, nowadays new alternative methods appear to be a promising modality of BRONJ treatment in early stages of the disease, while being safe and welltolerated, i.e. hyperbaric therapy, ozone therapy, use of platelet rich fibrine and platelet rich plasma, photodynamic therapy, low level laser therapy.