Bisphosphonate (BF) is a class of drugs that prevents bone resorption and remodeling, and have been efficiently and safely used to treat osteoporosis, hypercalcemia of malignancy, bone metastasis of solid malignant rumors, Peget’s disease of the bone.
However the use of (BF) was found to cause side effects of which BRONJ as the most adverse effect.
Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) can be described as an area of exposed necrotic bone in the mouth more than 8 weeks either affecting the maxilla or the mandible in a person taking any BF and had not had radiation therapy in the craniofacial region.
BRONJ rarely reported prior to 2001. In September 2004, Novartis: manufacturer of intravenous BF pamisronate (Aredia) and zoledronic acid (Zometa), notified healthcare professionals of additions of the labeling of these products which provides cautionary language related to the development of osteonecrosis of the jaw (ONJ). In 2005: the FDA issued warning for the entire drug class (including oral BF).
Treatment recommendations exist, but a standard therapy has not yet been established for BRONJ.
Ruggiero et al, in 2006 proposed guidelines for the diagnosis, staging and management of BRONJ. Later Ruggiero at al and the American Association of Oral and Maxillofacial Surgery (AAOMS) reported their position paper on BRONJ with an update of the previous classification (2014).
This lecture will cover:
-Their clinical applications
-drug chemistry and actions
-Side effects of BF
-Staging of BRONJ
-Treatment of BRONJ
-Latest management and recommendations
Dr. Randa Shaker
Consultant – Advanced General Dentistry
Department of Dentistry
King Faisal Specialist Hospital and Research Center- Jeddah
Present Position: Consultant – Advanced General Dentistry and Residency Program Director
Medical Degree: Bachelor of dental surgery, KSU,1993
AEGD, Ohio state university, Columbus, Oh, 1996
Masters in dental Science , Ohio state Uni, Columbus, Ohio, 1997
Residency in hospital dentistry, McGill University, Montreal, Quebec. 1999
Fellowship in Advance general dentistry 2001,
Specialty Training / Employment:
2003 August – Present Consultant- Advanced General Dentist.
King Faisal Specialist Hospital and Research Center - Jeddah
November 2007- Present Residency Program Director. KFSH&RC, Jeddah
2004- Present Member of the organization committee (CME) for the dental conferences held in KFSH&RC under our department
September 2002 - July 2003 Consultant- Advanced General Dentist.
King Faisal Specialist Hospital and Research Center – Jeddah
March 2002 – September 2002 Associate Consultant – General Dentist.
King Khalid National Guard Hospital, Jeddah Saudi Arabia
July 2001 – March 2002 Associate Professor, University of Saskatchewan, Canada
September 2000 – July 2001 Assistant Professor
Joined the Department of Community and Clinical Dentistry. The Department of Dentistry, University of Saskatchewan, Canada
December 1993 – April 1996 General Practitioner Riyadh Medical Complex, Riyadh Saudi Arabia
October 1998 – June 1999
Postgraduate Training in Hospital Dentistry, Montreal General Hospital, McGill University, Montreal, Quebec
July 1996 – June 1997
Residency In Advanced Education in General Dentistry, College of Dentistry, Ohio State University