Osteonecrosis of the jaw (onj)

[Jessica]

Osteonecrosis of the jaw is an oral lesion involving bare mandibular or maxillary bone. It may cause pain or may be asymptomatic. Diagnosis is by the presence of exposed bone for at least 8 weeks. Treatment is limited debridement, antibiotics, and oral rinses.
Osteonecrosis of the jaw (ONJ) has no unanimously accepted definition or etiology but is generally held to be an oral lesion involving bare mandibular or maxillary bone.
ONJ may occur spontaneously or after dental extraction or trauma, high-dose IV bisphosphonate therapy, or high-dose denosumab 120 mg subcutaneously once/month (eg, for cancer treatment). ONJ may be a refractory osteomyelitis rather than true osteonecrosis, particularly when associated with bisphosphonate use.
There is no evidence that routine use of oral bisphosphonates for treatment or prevention of osteoporosis increases risk of ONJ. Currently, otherwise appropriate bisphosphonate use should not be discouraged. However, it seems reasonable to do any necessary oral surgery before beginning IV bisphosphonate therapy and to encourage good oral hygiene and regular dental care while patients are taking bisphosphonates (1, 2).