# Bisphosphonate-Related Osteonecrosis of the Jaw: A 10-Year Analysis of Risk Factors and Clinical Outcomes

## TL;DR

This study analyzes 10 years of data to identify risk factors and outcomes for a rare but severe jaw condition caused by bisphosphonate drugs.

## Contribution

The study provides a 10-year retrospective analysis of BRONJ cases in a single clinic, identifying key risk factors and clinical outcomes.

## Key findings

- Most patients had malignancies, particularly breast and prostate cancers.
- Tooth extraction was the main trigger for BRONJ, and the mandible was most commonly affected.
- Comorbidities like hypertension and diabetes worsened BRONJ severity, requiring surgical intervention.

## Abstract

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a severe complication associated with bisphosphonate therapy commonly used in patients with osteoporosis and malignancies. Methods: This retrospective study evaluates the risk factors and clinical outcomes of BRONJ patients treated at the Oral and Maxillofacial Surgery Clinic in Iaşi, Romania, with the goal of optimizing preventive and therapeutic strategies. Data from 72 BRONJ patients treated between January 2013 and December 2023 were analyzed. Results: The majority (83.3%) of patients had underlying malignancies, predominantly breast and prostate cancers. The mandible was most affected, with tooth extraction identified as the primary triggering event. Systemic comorbidities, notably arterial hypertension, diabetes mellitus, and concurrent chemotherapy, were significantly associated with increased BRONJ severity. Surgical intervention was frequently required, with sequestrectomy being the predominant procedure, reflecting advanced disease at the time of diagnosis. Conclusions: The findings underline the critical importance of early identification, preventive dental management, and a collaborative multidisciplinary approach to improve patient prognosis.