Bisphosphonates and Their Connection to Dental Procedures: Exploring Bisphosphonate-Related Osteonecrosis of the Jaws

Emily Sunny Lee, Meng Chen Tsai, Jing Xuan Lee, Chuki Wong, You Ning Cheng, An Chi Liu, You Fang Liang, Chih Yuan Fang, Chia Yu Wu, I. Ta Lee

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Bisphosphonates are widely used to treat osteoporosis and malignant tumors due to their effectiveness in increasing bone density and inhibiting bone resorption. However, their association with bisphosphonate-related osteonecrosis of the jaws (BRONJ) following invasive dental procedures poses a significant challenge. This review explores the functions, mechanisms, and side effects of bisphosphonates, emphasizing their impact on dental procedures. Dental patients receiving bisphosphonate treatment are at higher risk of BRONJ, necessitating dentists’ awareness of these risks. Topical bisphosphonate applications enhance dental implant success, by promoting osseointegration and preventing osteoclast apoptosis, and is effective in periodontal treatment. Yet, systemic administration (intravenous or intraoral) significantly increases the risk of BRONJ following dental procedures, particularly in inflamed conditions. Prevention and management of BRONJ involve maintaining oral health, considering alternative treatments, and careful pre-operative and post-operative follow-ups. Future research could focus on finding bisphosphonate alternatives with fewer side effects or developing combinations that reduce BRONJ risk. This review underscores the need for further exploration of bisphosphonates and their implications in dental procedures.

Original languageEnglish
Article number5366
Issue number22
Publication statusPublished - Nov 2023


  • bisphosphonate-related osteonecrosis of the jaws
  • bisphosphonates
  • cancer
  • dentistry
  • inflammation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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