4.6 Review

Non-exposed bisphosphonate-related osteonecrosis of the jaw: a critical assessment of current definition, staging, and treatment guidelines

Journal

ORAL DISEASES
Volume 18, Issue 7, Pages 625-632

Publisher

WILEY
DOI: 10.1111/j.1601-0825.2012.01911.x

Keywords

diagnostics; medicine; craniofacial; oncology

Funding

  1. National Institute of Health [1R01DE019932]
  2. California Institute for Regenerative Medicine [RN1-00572]
  3. Oral and Maxillofacial Surgery Foundation [OMSF002894]
  4. Zumberge award
  5. CTSI

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Oral Diseases (2012) 18, 625632 Non-exposed bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a newly reported complication arising from bisphosphonate therapy that presents with atypical symptoms and no apparent mucosal fenestration or exposure of necrotic bone. The clinical observation of the presence of necrotic bone underneath normal epithelial coverage was not conclusive for the diagnosis of BRONJ based on current guidelines established by the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the American Society for Bone and Mineral Research (ASBMR), which specify the presence of clinically exposed necrotic bone for more than 8 weeks. Hence, the purpose of this review is to critically assess the current guidelines for diagnosis and management of BRONJ and propose a modified staging system and treatment guidelines to properly address the non-exposed variant of BRONJ lesions.

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