Osteonecrosis of the jaw has been increasingly suspected to be a potencial complication of biphosphonate terapy in the recent year. These drugs are used in the cronic treatment of osteopenic patients, an in protocols of oncologic patients. There are few papers that address the fisiopathogenia of ONJ. From may 2008 to January 2011 our department received 32 patients who were affected by bisphosphonate – related ON. Sintomatology was characterized by pain, purulent secretions, necrotic bone exposure, ulcer of oral mucose, and selling.
Pathophysiology : Bisphosphonate are believed to incrase the formation of hidroxiapatita crystals leading to avascular bone necrosis. In addicion Dr. Scheper el al. Suggested that zolendronic acid, at low concentration, directly affected oral mucosal tissues by induction of gen-regulated apoptotic processes, thus these soft tissue effects of the medication might induce or potentiate osteonecrosis.