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J Am Dent Assoc, Vol 140, No 7, 864-875.
© 2009 American Dental Association
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CLINICAL PRACTICE

Bisphosphonate and Nonbisphosphonate-Associated Osteonecrosis of the Jaw

A Review



Soulafa A. Almazrooa, BDS and Sook-Bin Woo, DMD

Background. The term "osteonecrosis of the jaw" (ONJ) is used almost synonymously with the term "bisphosphonate-associated ONJ." However, necrosis of the jawbones leading to exposure of bone is associated with other factors.

Types of Studies Reviewed. The authors conducted a literature search using PubMed to identify original research articles and case reports that described oral conditions and associated factors that result in sequestrum formation and bone exposure.

Results. After reviewing conditions that may lead to necrosis of the jawbones, the authors divided the causes of ONJ into the following conditions: systemic medication use; radiation; bacterial, viral and deep fungal infections; direct chemical toxicity; trauma; idiopathy; and other etiologies.

Clinical Implications. Clinicians should take a careful history when evaluating patients with ONJ because ONJ may result from one or more factors.

Key Words: Osteonecrosis of the jaw; bisphosphonates; antiangiogenic drugs; radiation; infection; trauma

Abbreviations: AAOMS: American Association of Oral and Maxillofacial Surgeons • BONJ: Bisphosphonate-associated osteonecrosis of the jaw • HBO: Hyperbaric oxygen • IMRT: Intensity-modulated radiotherapy • IV: Intravenous • NICO: Neuralgia-inducing cavitational osteonecrosis • ONJ: Osteonecrosis of the jaw • PRON: Postradiation osteonecrosis • TMJ: Temporomandibular joint




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A. Kyrgidis and K. Vahtsevanos
OSTEONECROSIS OF THE JAW
J Am Dent Assoc, October 1, 2009; 140(10): 1216 - 1217.
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