AAOMS Updates BRONJ Position Paper(such as periodontal disease and dental a...),Health

The 2009 BRONJ Position Paper offers some strategies for preventing BRONJ in cancer patients treated with IV bisphosphonates.

• Prior to initiation of cancer-related IV bisphosphonate treatment, patients should have a thorough dental examination and complete the necessary procedures to achieve optimal periodontal health.
• Given the long-term biologic activity of IV bisphosphonates noted in the literature, the 2009 Position Paper suggests that alternative dosing regimens that reduce bisphosphonate exposure may be effective in decreasing the risk for BRONJ.

Changes to the staging system include the addition of Stage 0, which includes patients exposed to bisphosphonates and who present with non-specific symptoms, or clinical and radiographic abnormalities.

BRONJ is painful and difficult to treat. While osteonecrosis of the jaw has been recognized by dental and medical practitioners for many years, the identification of bisphosphonates as a contributory factor to the condition was first reported by oral and maxillofacial surgeons about five years ago when they noticed an increase in the number of patients exhibiting the signs of ONJ. A review of these cases indicated that bisphosphonate therapy was a common thread.

In 2006, the American Association of Oral and Maxillofacial Surgeons appointed the Task Force on BRONJ to review the existing literature and prepare a position paper that synthesized the findings for the dental and medical communities.

In late 2008, the Task Force on BRONJ was reconstituted to rev
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