Bisphosphonates and osteonecrosis of the jaw: pathogenetic hypothesis and new preventive measures

2012

BRONJ is a serious oral complication of BP treatment involving the exposure of necrotic maxillary or mandibular bone. We investigated the pathogenetic hypothesis and new preventive measures for BRONJ in patients with bone metastases who received BP zoledronic acid (ZOL) and chemotherapy combined with the antiangiogenic agent bevacizumab (BEV). The pathogenesis of BRONJ is uncertain: the type of BP, duration of the drug use and the occurrence of tooth extractions or other invasive dental procedures during treatment seem to play a major role. A theory that BRONJ is a form of avascular necrosis similar to osteoradio-necrosis also has been proposed. It maybe hypothesized that the combination of…