Bisphosphonate-induced osteonecrosis of the jaw

Summary Bisphosphonates are widely used to treat osteoporosis. They inhibit normal bone turnover by inducing osteoclast apoptosis. This impedes normal remodelling, thereby preventing further deterioration in bone architecture. However, use of bisphosphonates for some years can lead to accumulation of old fragile bone, occlusion of haversian sinuses, and ultimately osteonecrosis and sequestrum formation. Dental extraction and other invasive dental procedures have been identified as risk factors for the development of bisphosphonate-induced osteonecrosis of the jaw. The role of a dentist is, in combination with a physician, to prevent and treat bisphosphonate-induced osteonecrosis of the jaw.