Keywords
bisphosphonates
bone antiresorptive agents
risk factors
How to Cite
Abstract
Bisphosphonate-induced osteonecrosis of the jaw (BIONJ) is a severe complication associated with prolonged use of antiresorptive agents, such as bisphosphonates, employed in the treatment of metastatic bone diseases and osteoporosis. This study aimed to analyze the pharmacological mechanisms, risk factors, and management strategies of BIONJ based on recent scientific evidence. A literature review was conducted in PubMed and Scielo, including 22 articles published between 2020 and 2025, which addressed incidence, pathophysiology, prevention, and treatment. In conclusion, bisphosphonate-induced osteonecrosis (BIONJ) exhibits variable incidence (0.8–16.3%) depending on the type, dose, and duration of the agent, associated with factors such as dental extractions, comorbidities, and periodontal health. Its mechanisms include prolonged osteoclastic suppression, osteocyte toxicity, and anti-angiogenic effects, with denosumab requiring specific monitoring. Preventive strategies combine local interventions (platelet-rich fibrin, laser) and systemic approaches (omega-3, pentoxifylline/tocopherol), effective in early stages, while multidisciplinary protocols and research on AI-based predictive models are necessary to optimize management.
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Copyright (c) 2025 Marco Antônio Franco Cançado, Francielle Nunes de Lira Cunha, Gabriela Cristina Baccaro, Mauricio Santos Souza, Tatiana Santos Rebouças, Carla Cristine Vieira Araújo Machado, Isabela Maria Gontijo Machado, Damián Marco Bertiz Loza, Maria Thaynara Lopes da Silva , Vitória Ribeiro de de Araújo, Gabriella Peres Cabral, Raimunda Rodrigues da Silva Brito, Karen Pollyana Corrêa Ferreira, Alice Angélica de Souza Pereira, Rodolfo Medeiros Gonçalves de Paiva, Amanda Cypriano Alves
