Use of Bisphosphonates and Antireesorptive Agents ARONJ

Bisphosphonated use

• Managment of osteoporosis

• Cancer of the bone

• chronic bone disease

• bone pain

• hypercalcemia

Types of Biphosphonates

Oral: Fosamax, Actonel, Boniva

IV: Aredia, Zometa

Antiresorptive agent: Denosumab

Risk factors for Antiresorptive Agent Induced ONJ (ARONJ)

• greater risk associated with IV forms of BIS

• greater risk: use of BIS for >2 years

• Increased risk from tooth extractions

• Denture irritations

• Bone trauma

• Periodontitis

Radiation induced Osteoradionecrosis (ORN) of the jaw

jaw necrosis following high dose of radiation to the head and neck area (ORN)