Bisphosphonate related osteonecrosis of the Jaws can be recognized by exposure of necrotic bone in the mouth, usually but not exclusively, secondary to a dental surgical procedure, especially dental extractions. Some reports mention that up to 50% of patients who develop BRONJ have a history of tooth extraction as a precipitating factor. Another triggering factor described is the presence of lingual or palatal torus. This condition, however, can also occur spontaneously.
A successful treatment of BRONJ has not been developed yet, which makes this condition a very difficult clinical challenge; however some authors have shown that prevention is the most adequate way to decrease the number of cases.
A protocol for prevention of this complication has been developed at the Oral and Maxillofacial Surgery Unit, Air Force Hospital Santiago, Chile and allows dental and medical general practitioners a simple and accurate method to guide patients in need of therapy with bisphosphonates. This protocol includes patients who require either oral or i/v therapy, considering concomitant medical conditions and advices a dental therapy prior to the onset of this drug.
Conflict of interest: None declared.