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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Mandible-maxilla (Md-Mx) osteonecrosis (ON)
Synonyms
Medication-related osteonecrosis of jaws
Bisphosphonate-related osteonecrosis of jaws
Definitions
Necrosis of mandible or maxilla associated with medication (often bisphosphonate) use
Nonhealing exposed bone, after 8 weeks, in patient with no history of prior craniofacial radiation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Bodem JP et al: Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III. Oral Surg Oral Med Oral Pathol Oral Radiol. 121(4):367-72, 2016
Kim HJ et al: Bisphosphonate-related osteonecrosis of the jaw in metastatic breast cancer patients: a review of 25 cases. Maxillofac Plast Reconstr Surg. 38(1):6, 2016
Kämmerer PW et al: Surgical evaluation of panoramic radiography and cone beam computed tomography for therapy planning of bisphosphonate-related osteonecrosis of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol. 121(4):419-24, 2016
Melville JC et al: A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: the combined buccal fat pad flap and radical sinusotomy. Oral Surg Oral Med Oral Pathol Oral Radiol. ePub, 2016
Rollason V et al: Interventions for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ). Cochrane Database Syst Rev. 2:CD008455, 2016
Taguchi A et al: Lack of cooperation between physicians and dentists during osteoporosis treatment may increase fractures and osteonecrosis of the jaw. Curr Med Res Opin. 32(7):1261-8, 2016
Krstevska S et al: Osteonecrosis of the Jaw After Bisphosphonates Treatment in Patients with Multiple Myeloma. Med Arch. 69(6):367-70, 2015
Bedogni A et al: Oral bisphosphonate-associated osteonecrosis of the jaw after implant surgery: a case report and literature review. J Oral Maxillofac Surg. 68(7):1662-6, 2010
Chiu CT et al: Resolution of oral bisphosphonate and steroid-related osteonecrosis of the jaw--a serial case analysis. J Oral Maxillofac Surg. 68(5):1055-63, 2010
Filleul O et al: Bisphosphonate-induced osteonecrosis of the jaw: a review of 2,400 patient cases. J Cancer Res Clin Oncol. 136(8):1117-24, 2010
Kyrgidis A et al: Dental extractions in patients receiving bisphosphonate therapy. J Oral Maxillofac Surg. 68(7):1704-6; author reply 1706, 2010
Lazarovici TS et al: Bisphosphonate-related osteonecrosis of the jaw associated with dental implants. J Oral Maxillofac Surg. 68(4):790-6, 2010
Lo JC et al: Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg. 68(2):243-53, 2010
Saia G et al: Occurrence of bisphosphonate-related osteonecrosis of the jaw after surgical tooth extraction. J Oral Maxillofac Surg. 68(4):797-804, 2010
Setabutr D et al: Necrotizing fasciitis secondary to bisphosphonate-induced osteonecrosis of the jaw. Am J Otolaryngol. 31(2):127-9, 2010
Yarom N et al: Is exposure of the jawbone mandatory for establishing the diagnosis of bisphosphonate-related osteonecrosis of the jaw? J Oral Maxillofac Surg. 68(3):705, 2010
Arrain Y et al: Bisphosphonates and osteonecrosis of the jaw--current thoughts. Dent Update. 36(7):415-9, 2009
Kyrgidis A et al: Bisphosphonate osteonecrosis of the jaws in cancer patients. Breast. 18(5):335, 2009
Morag Y et al: Bisphosphonate-related osteonecrosis of the jaw: a pictorial review. Radiographics. 29(7):1971-84, 2009
Ruggiero SL et al: American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw - 2009 update. Aust Endod J. 35(3):119-30, 2009
Ryan P et al: Osteonecrosis of the jaw: a rare and devastating side effect of bisphosphonates. Postgrad Med J. 85(1010):674-7, 2009
Khosla S et al: Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 22(10):1479-91, 2007
Mortensen M et al: Osteonecrosis of the jaw associated with bisphosphonate use: Presentation of seven cases and literature review. Laryngoscope. 117(1):30-4, 2007
Carneiro E et al: Bisphosphonate-associated mandibular osteonecrosis. AJNR Am J Neuroradiol. 27(5):1096-7, 2006
Farrugia MC et al: Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates. Laryngoscope. 116(1):115-20, 2006
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Mandible-maxilla (Md-Mx) osteonecrosis (ON)
Synonyms
Medication-related osteonecrosis of jaws
Bisphosphonate-related osteonecrosis of jaws
Definitions
Necrosis of mandible or maxilla associated with medication (often bisphosphonate) use
Nonhealing exposed bone, after 8 weeks, in patient with no history of prior craniofacial radiation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Bodem JP et al: Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III. Oral Surg Oral Med Oral Pathol Oral Radiol. 121(4):367-72, 2016
Kim HJ et al: Bisphosphonate-related osteonecrosis of the jaw in metastatic breast cancer patients: a review of 25 cases. Maxillofac Plast Reconstr Surg. 38(1):6, 2016
Kämmerer PW et al: Surgical evaluation of panoramic radiography and cone beam computed tomography for therapy planning of bisphosphonate-related osteonecrosis of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol. 121(4):419-24, 2016
Melville JC et al: A technique for the treatment of oral-antral fistulas resulting from medication-related osteonecrosis of the maxilla: the combined buccal fat pad flap and radical sinusotomy. Oral Surg Oral Med Oral Pathol Oral Radiol. ePub, 2016
Rollason V et al: Interventions for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ). Cochrane Database Syst Rev. 2:CD008455, 2016
Taguchi A et al: Lack of cooperation between physicians and dentists during osteoporosis treatment may increase fractures and osteonecrosis of the jaw. Curr Med Res Opin. 32(7):1261-8, 2016
Krstevska S et al: Osteonecrosis of the Jaw After Bisphosphonates Treatment in Patients with Multiple Myeloma. Med Arch. 69(6):367-70, 2015
Bedogni A et al: Oral bisphosphonate-associated osteonecrosis of the jaw after implant surgery: a case report and literature review. J Oral Maxillofac Surg. 68(7):1662-6, 2010
Chiu CT et al: Resolution of oral bisphosphonate and steroid-related osteonecrosis of the jaw--a serial case analysis. J Oral Maxillofac Surg. 68(5):1055-63, 2010
Filleul O et al: Bisphosphonate-induced osteonecrosis of the jaw: a review of 2,400 patient cases. J Cancer Res Clin Oncol. 136(8):1117-24, 2010
Kyrgidis A et al: Dental extractions in patients receiving bisphosphonate therapy. J Oral Maxillofac Surg. 68(7):1704-6; author reply 1706, 2010
Lazarovici TS et al: Bisphosphonate-related osteonecrosis of the jaw associated with dental implants. J Oral Maxillofac Surg. 68(4):790-6, 2010
Lo JC et al: Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg. 68(2):243-53, 2010
Saia G et al: Occurrence of bisphosphonate-related osteonecrosis of the jaw after surgical tooth extraction. J Oral Maxillofac Surg. 68(4):797-804, 2010
Setabutr D et al: Necrotizing fasciitis secondary to bisphosphonate-induced osteonecrosis of the jaw. Am J Otolaryngol. 31(2):127-9, 2010
Yarom N et al: Is exposure of the jawbone mandatory for establishing the diagnosis of bisphosphonate-related osteonecrosis of the jaw? J Oral Maxillofac Surg. 68(3):705, 2010
Arrain Y et al: Bisphosphonates and osteonecrosis of the jaw--current thoughts. Dent Update. 36(7):415-9, 2009
Kyrgidis A et al: Bisphosphonate osteonecrosis of the jaws in cancer patients. Breast. 18(5):335, 2009
Morag Y et al: Bisphosphonate-related osteonecrosis of the jaw: a pictorial review. Radiographics. 29(7):1971-84, 2009
Ruggiero SL et al: American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw - 2009 update. Aust Endod J. 35(3):119-30, 2009
Ryan P et al: Osteonecrosis of the jaw: a rare and devastating side effect of bisphosphonates. Postgrad Med J. 85(1010):674-7, 2009
Khosla S et al: Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 22(10):1479-91, 2007
Mortensen M et al: Osteonecrosis of the jaw associated with bisphosphonate use: Presentation of seven cases and literature review. Laryngoscope. 117(1):30-4, 2007
Carneiro E et al: Bisphosphonate-associated mandibular osteonecrosis. AJNR Am J Neuroradiol. 27(5):1096-7, 2006
Farrugia MC et al: Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates. Laryngoscope. 116(1):115-20, 2006
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