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Bisphosphonate-related osteonecrosis of the jaws (BRON)

Bisphosphonates are a recognized and effective class of drugs used intravenously to treat multiple cancer-related conditions. They are also used orally in the prevention of osteopenia and osteoporosis, and include commonly-prescribed name brand preparations such as Fosamax and Boniva. Oral surgeons found themselves on the front lines when a severe side effect—osteonecrosis of the jaws—presented among some patients treated with bisphosphonates.

“This is an example of how clinical investigation can change medical and dental practice real-time,” says Dr. Dodson. “Our methodical review of evidence is helping to minimize the occurrence of side effects while preserving the availability of a drug that is excellent at treating aggressive types of cancers.”

As a member of the Advisory Task Force appointed by the American Association of Oral and Maxillofacial Surgeons (AAOMS), Dr. Thomas B. Dodson, CACI director, participated in creating a position paper on bisphosphonate-related osteonecrosis of the jaws. "This document contains our collective knowledge to date on risk factors for BRON, as well as guidelines for treating affected patients," Dr. Dodson says. See the 2009 update of this document »

Bibliography

TB Dodson, Sung-Kiang Chuang. Frequency Estimates of BRON – Is it really zero? J Oral Maxillofac Surg, July, 2008

Wessel JH, Dodson TB, Zavras AI. Zoledronate, smoking and obesity are strong risk factors for osteonecrosis of the jaw: a case-control study. J. Oral Maxillofac Surg, 64(4) 625-31, 2008.

TB Dodson, NS Raje, PA Caruso, AE Rosenberg. Case 9-2008—A 65-year-old woman with a non-healing ulcer of the jaw. New England Journal of Medicine, March 20, 2008, 358(12): 1283-1291.

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