What is the Origin of Osteonecrosis of the Jaw?

The term is derived from Greek roots: osteo- (bone), -necr- (death), and -osis (condition), specifically localized to the jawbones. Its emergence as a distinct clinical entity gained prominence following the widespread use of potent nitrogen-containing bisphosphonates in the early 2000s, leading to the coining of the term Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ). The condition highlights the complex interplay between systemic pharmacological agents and local bone metabolism and healing capacity.

What is the Mechanism of Osteonecrosis of the Jaw?

The underlying mechanism is recognized as multifactorial but is strongly linked to the profound suppression of bone turnover induced by antiresorptive drugs, particularly in areas of high bone remodeling like the jaw following trauma or dental extraction. The impaired osteoclast function and reduced bone remodeling capacity compromise the bone's ability to repair microdamage and resist infection, leading to localized ischemia and subsequent bone death. This pathological cascade is exacerbated by local factors such as dental disease, mechanical stress from dentures, or surgical intervention.

Osteonecrosis of the Jaw

Meaning

Osteonecrosis of the Jaw (ONJ) is a severe, debilitating condition characterized by the progressive destruction and death of bone tissue in the maxilla or mandible, which leads to an area of exposed bone that fails to heal for an extended period. Clinically, this complication is most frequently associated with the use of potent antiresorptive medications, such as bisphosphonates or denosumab, often prescribed for osteoporosis or bone metastases, conditions intrinsically linked to hormonal changes and aging. It represents a serious adverse event in the management of bone health, requiring careful monitoring and multidisciplinary dental and medical management. The condition significantly impairs the patient’s quality of life and oral function.