It is important to understand that patients at risk for BRONJ or with established BRONJ can also present with other common clinical conditions that should not be confused as BRONJ.
In the vast majority of BRONJ cases reported to date, recent dentoalveolar trauma was the most prevalent and consistent risk factor.
1) While this approach is not necessary for patients who are about to begin oral bisphosphonate therapy, the importance of regular dental care should be stressed, and the patient should be educated as to the signs and symptoms of BRONJ.
The goals of therapy in patients with established BRONJ are to eliminate pain and infection and minimize the progression of necrosis (Table III).
Eventually, using a relatively simple genetic test will allow categorizing the risk of cancer treated patients to develop BRONJ and thus lead to personalized cancer treatment.
Noam Yarom, Director of the Oral Medicine Clinic at the Sheba Medical Center, Tel-Hashomer, commented, "The study results are highly encouraging as no reliable test for predicting BRONJ exists in the market today.
The BRONJ side-effect appears in cancer patients who receive intravenous therapy (approximately 500,000 patients each year) with a prevalence rate of up to 18.
side effect appears in cancer patients who receive intravenous therapy (approximately 500,000 patients each year) with a prevalence rate of up to 18.
Oral and maxillofacial surgeons, who counsel, manage and treat a majority of BRONJ patients, report that patients taking oral bisphosphonates are at a significantly lower risk for the disease than those taking the drug intravenously.
Patients receiving IV bisphosphonates AND undergoing dentoalveolar surgery are more likely to develop BRONJ than patients who are not having such surgery.
While recognizing the value of IV bisphosphonates for adjunct cancer treatment, the AAOMS Strategies for prevention of BRONJ state that, if systemic conditions permit, the following should occur prior to treatment with an IV bisphosphonate:
Patients taking oral bisphosphonates are at a significantly reduced risk of developing BRONJ than those being treated with IV bisphosphonates.