Bisphosphonate-related osteonecrosis of the jaw successfully treated with surgical resection and its histopathological features: A long-term follow-up report

Bisphosphonates (BP) are potent inhibitors of the osteoclast activity used in the treatment of metastatic bone disease and osteoporosis. Bisphosphonate related osteonecrosis of the jaw (BRONJ) is a rare, but severe complication as a pathological fracture, pain and tumor-induced hypercalcemia. Patients taking BP may subsequently develop BRONJ after dentoalveolar surgery or trauma of the oral mucosa. However, appropriate approaches for the prevention and treatment of BRONJ have not been established. One of reasons is that the pathogenesis of BRONJ is poorly understood. We reported a case of BRONJ in a 77-year-old woman that was successfully treated by segmental resection of the extensive necrotic bone and a pathological fracture in the mandible. We describe the rare histopathological features of the resected specimen.