Osteonecrosis of the jaw

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Osteonecrosis of the jaw
File:ONj left maxilla.JPG
Synonyms	ONJ, Dead jaw syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Pain, swelling, exposed bone in the mouth
Complications	Infection, fracture of the jaw
Onset	Typically after dental surgery or tooth extraction
Duration	Can be chronic
Types	N/A
Causes	Bisphosphonate use, Radiation therapy, Chemotherapy
Risks	Cancer, Osteoporosis, Periodontal disease
Diagnosis	Clinical examination, X-ray, CT scan
Differential diagnosis	Osteomyelitis, Periodontitis, Gingivitis
Prevention	Avoidance of invasive dental procedures during bisphosphonate therapy
Treatment	Antibiotics, Surgery, Hyperbaric oxygen therapy
Medication	N/A
Prognosis	Variable, can be difficult to treat
Frequency	Rare, more common in patients receiving high-dose bisphosphonates
Deaths	N/A

File:TimelineONJ1.jpg

timeline of osteonecrosis of the jaw

Osteonecrosis of the Jaw (ONJ) is a severe bone disease that affects the jaws, including the maxilla and the mandible. It is characterized by the loss of blood supply to the bones, leading to bone death and eventual collapse of the affected area.

Causes

ONJ is often associated with the use of certain medications, particularly bisphosphonates and denosumab, which are used to treat osteoporosis and certain types of cancer. Other potential causes include radiation therapy to the head or neck, severe infection, or trauma to the jaw.

Symptoms

Symptoms of ONJ may include pain, swelling, or infection of the gums or jaw, loose teeth, and exposed bone. In severe cases, it can lead to difficulty eating or speaking, and may require surgical intervention.

Diagnosis

Diagnosis of ONJ is typically made through a combination of medical history, physical examination, and imaging studies such as X-rays or CT scans. A biopsy may also be performed to rule out other conditions.

Treatment

Treatment for ONJ focuses on eliminating the infection, preserving bone health, and managing symptoms. This may involve antibiotics, oral rinses, and pain management. In severe cases, surgical debridement or resection may be necessary.

Prevention

Prevention strategies for ONJ include good oral hygiene, regular dental check-ups, and avoiding invasive dental procedures when possible. Patients taking bisphosphonates or denosumab should discuss the risks and benefits with their healthcare provider.

See also

• Bisphosphonate-associated osteonecrosis of the jaw
• Osteoporosis
• Osteonecrosis