Bisphosphonate Related Osteonecrosis of Maxilla Following Implant Failure – A Case Report

Abstract

Marx in the year 2003 , defined osteonecrosis of the jaw ( ONJ) as exposed , necrotic bone in the maxillofacial region  for atleast eight weeks in patients receiving anti – resorptive medication for primary or metastatic bone cancer , osteoporosis or Paget’s disease , without history of radiation therapy to the jaws ¹.  The AAOMS ,  modified the above definition to include exposed bone , or bone that can be probed through an intra oral or extra oral fistula in patients who are on antiresorptive or anti angiogenic medications ².

Bisphosphonates treatment has been found to be a major factor contributing to the development of osteonecrosis of the jaws . Bisphosphonate related osteonecrosis of the jaws is the most common side effect of bisphosphonate treatment , without previous history of radiation therapy to the jaws ¹.  According to Kurtzman , it is considered to be a long term and irreversible , even on discontinuation of drugs³.