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💊intro to pharmacology review

Osteonecrosis of the jaw

Written by the Fiveable Content Team • Last updated September 2025
Written by the Fiveable Content Team • Last updated September 2025

Definition

Osteonecrosis of the jaw (ONJ) is a condition characterized by the death of bone tissue in the jaw, often associated with the use of certain medications that affect bone metabolism and calcium homeostasis. It is commonly linked to the use of bisphosphonates and other anti-resorptive agents used to treat osteoporosis and certain cancers, leading to complications such as pain, swelling, and exposed bone in the mouth.

5 Must Know Facts For Your Next Test

  1. Osteonecrosis of the jaw primarily occurs in patients receiving intravenous bisphosphonates for cancer treatment, particularly those with multiple myeloma or metastatic breast cancer.
  2. Risk factors for developing ONJ include dental procedures, poor oral hygiene, and concurrent use of corticosteroids.
  3. Symptoms of ONJ can include pain in the jaw, swelling, exposed bone, and infections in the mouth.
  4. ONJ is considered a rare but serious side effect of bisphosphonates, prompting healthcare providers to monitor patients closely during treatment.
  5. Preventative measures for ONJ may include dental evaluations before starting bisphosphonate therapy and maintaining good oral hygiene.

Review Questions

  • What is the relationship between bisphosphonates and osteonecrosis of the jaw, and how does this impact patient management?
    • Bisphosphonates are a class of drugs that inhibit bone resorption, which can inadvertently lead to osteonecrosis of the jaw in some patients. This relationship is particularly significant for those receiving intravenous bisphosphonates for cancer treatment. Patient management involves careful dental evaluations before starting therapy, maintaining oral hygiene, and being vigilant about any signs or symptoms that could indicate the onset of ONJ.
  • Discuss the risk factors associated with developing osteonecrosis of the jaw in patients undergoing treatment with anti-resorptive agents.
    • Several risk factors contribute to the development of osteonecrosis of the jaw in patients receiving anti-resorptive agents like bisphosphonates. Dental procedures such as extractions can increase risk due to compromised blood supply to the jawbone. Additionally, conditions like poor oral hygiene can exacerbate issues since bacteria may lead to infections that worsen bone health. Understanding these risks is crucial for both prevention and early identification of ONJ.
  • Evaluate the significance of early detection and preventive strategies for osteonecrosis of the jaw in patients treated with medications affecting bone metabolism.
    • Early detection of osteonecrosis of the jaw is critical due to its potential to cause significant morbidity. Preventive strategies include conducting thorough dental assessments prior to initiating treatment with medications like bisphosphonates and ensuring patients maintain optimal oral hygiene. These approaches not only help mitigate risks but also enhance overall patient outcomes by preventing complications that can arise from untreated ONJ. Addressing these elements emphasizes the importance of interdisciplinary care involving dental professionals in managing patients on these therapies.