In the last several years, reports of patients treated with bisphosphonates
(primarily those delivered intravenously) have emerged associating their use
with osteonecrosis of the jaw (ONJ). More than a thousand cases of bisphosphonate-associated
ONJ have been identified since the first cases were reported in 2001. In these,
ONJ rarely occurs "spontaneously"; the vast majority have been associated
as a consequence to oral surgical procedures. Although most of the reports of
ONJ have occurred in patients following the use of high dose IV therapy for
metastatic bone disease, there are also reports of ONJ in patients taking oral
bisphosphonates. Since millions of patients take oral bisphosphonates for the
treatment of osteoporosis, it is timely to review what is known and needs to
be learned about this emerging issue in patient care—to develop a consensus
on the definition of ONJ, as well as to explore potential risk factors and pathogenic
mechanisms of ONJ and to explore strategies to move research forward.
This volumes seeks to improve awareness of the condition and the need for increased screening and improved diagnosis of ONJ. It also explores possible treatment options for ONJ to help guide future areas for research.