Intravenous Bisphosphonate Therapy and Bisphosphonate-Related Osteonecrosis of the Jaws
The purposes of this report are to 1) summarize the epidemiologic evidence supporting an association between intravenous bisphosphonate (BP) exposure and BP-related osteonecrosis of the jaws (BRONJ), 2) identify measurable risk factors associated with BRONJ, and 3) assess the risk of BRONJ for patients receiving intravenous BPs to manage osteoporosis. The results of this review suggest a compelling, circumstantial association between intravenous BP exposure and BRONJ. The factors consistently associated with an increased risk of BRONJ included intravenous BP exposure in the setting of malignancy and dentoalveolar procedures. Finally, intravenous BP therapy for osteoporosis does not measurably increase the risk of BRONJ among postmenopausal women.
⁎Associate Professor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, and Visiting Oral and Maxillofacial Surgeon and Director, Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
Address correspondence and reprint requests to Dr Dodson: Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Warren 1201, Boston, MA 02114
Preparation of this manuscript was supported by the Massachusetts General Hospital, Department of Oral and Maxillofacial Surgery's Center for Applied Clinical Investigation and Education and Research Fund and Massachusetts General Physicians Organization.
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