Oral bisphosphonate therapy and osteonecrosis of the jaw: What to tell the concerned patient

Sreenivas Koka, Bart L. Clarke, Shreyasee Amin, Morie Gertz, Salvatore L. Ruggiero

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Bisphosphonate-associated osteonecrosis of the jaw (BONJ) is encountered predominantly in cancer populations being treated with high-dose intravenous bisphosphonates for skeletal complications such as bone metastases and secondary fracture risk. A minority of BONJ lesions have been observed in patients receiving oral bisphosphonates for management of osteoporosis or osteopenia. In this paper, the current knowledge pertaining to the incidence, definition, and signs and symptoms of BONJ is presented, followed by a discussion of the incidence and consequences of osteoporotic skeletal fracture and the use of oral bisphosphonates to mitigate fracture. The risk of BONJ appears to be very small in patients taking oral bisphosphonates. In addition, the consequences of osteoporotic fracture likely have significantly greater mortality and morbidity than BONJ. Within this context, management concepts and guidelines are presented to help the dental clinician allay concerns about BONJ expressed by patients receiving oral bisphosphonate therapy.

Original languageEnglish (US)
Pages (from-to)115-122
Number of pages8
JournalInternational Journal of Prosthodontics
Issue number2
StatePublished - Mar 2007

ASJC Scopus subject areas

  • Oral Surgery


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