Bisphosphonate induced osteonecrosis

Bisphosphonates:  Inhibit bone resorption and secondary bone renewal by suppressing the recruitment and activity of osteoclasts thus shortening their life span.

 Also Inhibit capillary neoangiogenesis leading to avascular necrosis.

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Bisphosphonates

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Cause of Bone Exposures

Mean induction time for bone exposure and symptoms was:

Most Common Areas of Bone Exposure

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Distribution in the Jaws

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Findings presenting in addition to exposed bone:

Prevention Recommendations

7.  Bisphosphonates need not be delayed for

Treatment

Treatment

Goals in treatment

8.  Patients should be followed every 4 months.