Diagnosis and management of antiresorptive-related osteonecrosis of the jaw.

Antiresorptive medications have proven to be extremely efficacious in the treatment of disorders of bone remodeling and metabolism. However, the benefits of these agents have been offset to some degree by the occurrence of jaw necrosis in a subset of patients receiving these medications. This complication was first reported in 2004; since then there have been multiple retrospective, prospective, and case-controlled studies that have defined the diagnosis, associated risk factors, and treatment outcomes for this unique complication. The risk of developing this complication appears to be related to the potency of the antiresorptive, the duration of exposure, and dentoalveolar trauma. Stage-specific management strategies have been developed, as well as guidelines for evaluating the potential risks associated with this complication. Recent clinical, in vivo, and in vitro studies have made significant progress toward understanding anti-resorptive osteonecrosis of the jaw.