A Review: Bisphosphonate Related Osteonecrosis of the Jaw: A Closer Look at Some of the Current Research Findings and an Elaboration on Recommended Treatment with an Emphasis on Conservative Treatment

This honors thesis examines the current findings in literature regarding bisphosphonate related osteonecrosis of the jaw (BRONJ). It is a review of 62 primary journal articles, secondary journal articles, case reports, and other reviews. The objective of this honors thesis is to examine the metabolic activity, clinical and biological effects, and history of bisphosphonate medications, as well as the epidemiology, risk factors, prevention, and treatment of BRONJ. This was accomplished by examination of the mechanism of action of nitrogen-containing and non nitrogen-containing bisphosphonates, and assessment of the possible links between taking oral and intravenous bisphosphonates and developing BRONJ. This honors thesis holds that debrideing the affected area is not an effective treatment strategy for stage 0, 1, and 2 BRONJ cases that resulted from the use of oral and intravenous bisphosphonates. This is because the irritation caused by tampering with the affected area prevents healing and promotes further decay of the jaw bone. However, some literature says that resection of BRONJ of the maxilla in patients taking an oral or intravenous bisphosphonate medication follows a predictable course with regard to healing. This honors thesis should be used to further educate oral and maxillofacial surgeons, periodontists, endodontists, general dentists, and orthodontists on the complications associated with patients using bisphosphonates and how best to implement their dental care