Aseptic necrosis of the jaw when using bisphosphonates: etiopathogenetic and preventive aspects

The article analyzes modern scientific research on bisphosphonate-associated osteonecrosis of the jaw (BONJ). It has been shown that a significant place in the etiology of BONJ is occupied by the features of the craniofacial region, as well as microbial infections, periodontal diseases in addition to tooth extraction, implant placement and other dental interventions. It has been revealed that a great importance in the pathogenesis of BONJ is attached to a change in cellular immunity, a negative effect on angiogenesis. In order to prevent BONJ, an integrated approach is proposed (a doctor prescribing treatment; a dentist; a periodontist and a dental hygienist) to the management of patients undergoing Bisphosphonates therapy, observing the time between taking Bisphosphonates and dental interventions, oral sanitation, patient education and raising awareness of doctors in the field of BONJ. Further clinical and basic scientific research is needed to gain a more complete understanding of the pathophysiology underlying BONJ and prevention methods.