Comprehensive approach to the treatment and prevention of bisphosphonate-induced osteonecrosis of the jaw

Osteonecrosis of the jaws (ONJ) is a severe complication associated with the administration of bisphosphonates, drugs used for the treatment of osteoporosis and metastatic bone disease. Bisphosphonates inhibit osteoclastic activity, preventing bone resorption and improving bone strength. However, these drugs can lead to ONJ, characterized by necrosis of the jaw bone tissue, inflammation of the surrounding soft tissues, chronic pain, and an increased risk of pathological fractures. The aim of this article is to provide a comprehensive review of current data on the pathogenesis, risk factors, diagnosis, treatment, and prevention of ONJ caused by the use of bisphosphonates. The article discusses the latest advancements in understanding the pathogenesis of ONJ, including the role of systemic comorbidities and oral diseases. Current diagnostic strategies for this condition are presented. Special attention is given to the differences in the incidence of ONJ with the use of different types of bisphosphonates. Innovative prevention and treatment methods are also discussed. Understanding the pathogenesis and risk factors of ONJ is crucial for developing effective prevention and treatment strategies, which can significantly improve the quality of life for patients taking bisphosphonates.