Non-exposed Bisphosphonate-related Osteonecrosis of the Jaw: A Critical Assessment of Current Definition, Staging, and Treatment Guidelines

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Departmental Papers (Dental)
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Author keywords: Craniofacial
Diagnostics
Medicine
Oncology MeSH: Angiogenesis Inhibitors
Anti-Bacterial Agents
Antibodies
Monoclonal
Humanized
Bisphosphonate-Associated Osteonecrosis of the Jaw
Humans
Jaw Diseases
Osteonecrosis
Practice Guidelines as Topic
Terminology as Topic EMTREE drug terms: antibiotic agent
bisphosphonic acid derivative EMTREE medical terms: adverse drug reaction
antibiotic therapy
article
disease course
human
jaw osteonecrosis
medical assessment
nonexposed bisphosphonate related jaw osteonecrosis
practice guideline
priority journal
staging
Dentistry
Oral and Maxillofacial Surgery
Oral Biology and Oral Pathology
Periodontics and Periodontology
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Patel, S
Choyee, S
Uyanne, J
Nguyen, A L
Lee, P
Sedghizadeh, P P
Kumar, S K S
Lytle, J
Shi, S
Le, A D
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Abstract

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 8weeks. 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. © 2012 John Wiley & Sons A/S.

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2012-10-01
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Oral Diseases
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At the time of publication, author Songtao Shi was affiliated with Herman Ostrow School of Dentistry of University of Southern California. Currently, (s)he is a faculty member at the School of Dental Medicine at the University of Pennsylvania. At the time of publication, author Anh D. Le was affiliated with Herman Ostrow School of Dentistry of University of Southern California and LAC+USC Medical Center. Currently, (s)he is a faculty member at the School of Dental Medicine at the University of Pennsylvania.
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