Bisphosphonates (BPs) are structural analogs of the pyrophosphate, with a high affinity for the bone tissue. BPs decrease osteoclastic activity and are used to treat bone metabolic diseases involving excessive bone resorption. Long-term therapies with BPs have been associated to the development of osteonecrosis of the jaw. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical entity characterized by exposed and necrotic bone, in maxillofacial region, persisting more than eight weeks without healing (after identification by an health care provider) in a patient who is taking, or has taken, a bisphosphonate and has not been submitted to head and neck radiation therapy. The majority of reported cases of osteonecrosis of the jaw have been associated to intravenous formulations, which present higher potency and bioavailability than oral bisphosphonates. This literature review addresses the etiologic factors to the development of BRONJ, as well as the clinical presentation. This review was based on scientific papers published in journals which are indexed to PUBMED®, between 2000 and 2009. Inclusion and exclusion criteria were not used due to the limited number of papers about this issue.
Coelho, A. I., Gomes, P. de S., & Fernandes, M. H. (2010). Osteonecrose dos maxilares associada ao uso de bifosfonatos. Parte I: Etiologia e apresentação clínica. Revista Portuguesa de Estomatologia, Medicina Dentaria e Cirurgia Maxilofacial, 51(2), 95–101. https://doi.org/10.1016/S1646-2890(10)70093-5