Bisphosphonate-related osteonecrosis of jaw (BRONJ): diagnostic criteria and possible pathogenic mechanisms of an unexpected anti-angiogenic side effect

Sharma, Dileep, Ivanovski, Saso, Sleven, Mark, Hamlet, Stephen, Pop, Tudor S., Brinzaniuc, Klara, Petcu, Eugen B., and Miroiu, Rodica (2013) Bisphosphonate-related osteonecrosis of jaw (BRONJ): diagnostic criteria and possible pathogenic mechanisms of an unexpected anti-angiogenic side effect. Vascular Cell, 5. 1. pp. 1-8.

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Recently, bisphosphonates (BPs) have been widely used in medical practice as anti-resorptive agents owing to their anti-osteoclatic action. In addition, these compounds are also used for their analgesic action and their potential anti-tumour effect. Patients treated with BPs may subsequently develop osteonecrosis of the jaw or maxillary bone after minor local trauma including dental work, recently labelled as bisphosphonate osteonecrosis of jaw (BRONJ). However, the etiopathogenic mechanisms of this pathological condition are poorly understood. Although, several pathways have been proposed for BRONJ occurrence, no single model can explain all morphological changes observed at the macro- and microscopic level. Recent research suggests that BPs may promote an anti-angiogenic effect which contributes directly to the clinical features associated with BRONJ. Remarkably, the anti-angiogenic effect promoting BRONJ might be in keeping with the anti-neoplastic action of BPs. The current review, presents clinical diagnostic criteria. In addition, based on our own experience we describe the histopathological criteria for diagnosis of BRONJ and the possible pathways which may lead to this frustrating pathological condition.

Item ID: 44281
Item Type: Article (Research - C1)
ISSN: 2045-824X
Keywords: alendronic acid; bisphosphonic acid derivative; clodronic acid; etidronic acid; ibandronic acid; olpadronic acid; pamidronic acid; risedronic acid; tiludronic acid; vasculotropin; zoledronic acid, adverse outcome; antiangiogenic activity; bone metastasis; breast cancer; clinical feature; drug safety; health care personnel; histopathology; human; hypercalcemia; jaw osteonecrosis; multiple myeloma; osteocyte; osteoporosis; Paget bone disease; priority journal; review; vascularization
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© Sharma et al.; licensee BioMed Central Ltd. 2013 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Date Deposited: 16 Jun 2016 01:05
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1105 Dentistry > 110505 Oral Medicine and Pathology @ 30%
11 MEDICAL AND HEALTH SCIENCES > 1105 Dentistry > 110509 Special Needs Dentistry @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1105 Dentistry > 110502 Dental Therapeutics, Pharmacology and Toxicology @ 30%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920113 Oro-Dental Disorders @ 100%
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