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Journal of Dental Research
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*Osteonecrosis
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Osteonecrosis of the Jaws and Bisphosphonate Therapy

S.L. Ruggiero1,2,* and S.J. Drew2

1 Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Long Island Jewish Medical Center, Division of Oral and Maxillofacial Surgery, New Hyde Park, NY; and
2 New York Center for Orthognathic and Maxillofacial Surgery, 2001 Marcus Ave., Suite N10, Lake Success, NY 11042, USA


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  		Figure 1. Clinical and radiographic appearance of osteonecrosis of the jaws. (A) Non-healing extraction site in a patient with breast cancer and a history of zolendronic acid exposure. (B) Spontaneous necrosis of the right posterior maxillary alveolus in a patient with prostate cancer and a history of pamidronate exposure. (C) Extra-oral draining fistula in a patient with Stage 3 BRONJ. (D) Extensive necrosis of the anterior mandible in a patient with a history of metastatic breast cancer and long-term zolendronic acid exposure (Stage 3 BRONJ). (E) Axial CT scan of the mandible osteolysis of the left mandible with sequestrum formation in a multiple myeloma patient. (F) Panoramic radiograph demonstrating a pathologic fracture and osteolysis of the left mandible (Stage 3 BRONJ) in a patient exposed to long-term pamidronate therapy.

 

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  		Figure 2. BRONJ Staging.

 

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  		Figure 3. BRONJ treatment guidelines.

 

Journal of Dental Research, Vol. 86, No. 11, 1013-1021 (2007)
DOI: 10.1177/154405910708601101
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