Clinical proposal demonstrates decision-making algorithms for osteonecrosis of the jaw in patients on antiresorptives, highlighting stage-dependent surgical management.
Background Osteonecrosis of the jaws is associated with various drugs, including antiresorptives such as bisphosphonates and denosumab, as well as antiangiogenics. These drugs are used for the treatment of multiple diseases, notably osteoporosis, bone metastases, Paget's disease, osteogenesis imperfecta, malignant hypocalcaemia, among others, that are important to consider. Bone turnover in the alveolar bone is 10 times faster than in long bones; this is why osteonecrosis always begins in the jaws. Discussion It is essential to inform dentists and healthcare providers of this risk when patients use drugs associated with this condition to establish proper management of the underlying disease and to raise awareness about its possible complications. Over the years, the treatment phases have been modified considering both conservative and surgical management depending on the stage of the disease in which each patient is classified, so it is important to establish a decision‐making algorithm for its appropriate management. Conclusion This is a proposal of different algorithms that could guide dentists in taking different decisions in the management of osteonecrosis of the jaws, as it is known, this condition has become more common.
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Alexandra et al. (2026) studied this question.
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