Managing the Adverse effects of Bishosphonate Theraphonthejaw
Journal of Amerian Academy of Physician Assistants (JAAPA), 22(11), November 2009
Denise Rizzolo, Ph.D., PA-C Physician Assistant Program
Mona M Sedrak, Ph.D., PA-CPhysician Assistant Program
More than 100 years ago, unexplainable, nonhealing bone exposures were seen on the jaws of phosphate miners and match workers in the United States and Great Britain. At that time, the condition was diagnosed as an occupational industrial disease called phossy jaw. The daily exposure to phosphate was postulated to cause an accumulation of the compound in the jaw, eventually leading to bone necrosis.
Today, a similar pattern of exposed, nonhealing bone is being seen in patients taking bisphosphonates. This phenomenon is referred to as bisphosphonate-related osteonecrosis of the jaws (BRONJ). Osteonecrosis is bone death resulting from poor blood supply to an area of bone. However, no universal definition of BRONJ has been established to date, making the diagnosis and determining the actual prevalence of the disease difficult.