Intravenous Bisphosphonate Therapy and Bisphosphonate-Related Osteonecrosis of the Jaws

The purposes of this report are to 1) summarize the epidemiologic evidence supporting an association between intravenous bisphosphonate (BP) exposure and BP-related osteonecrosis of the jaws (BRONJ), 2) identify measurable risk factors associated with BRONJ, and 3) assess the risk of BRONJ for patients receiving intravenous BPs to manage osteoporosis. The results of this review suggest a compelling, circumstantial association between intravenous BP exposure and BRONJ. The factors consistently associated with an increased risk of BRONJ included intravenous BP exposure in the setting of malignancy and dentoalveolar procedures. Finally, intravenous BP therapy for osteoporosis does not measurably increase the risk of BRONJ among postmenopausal women.