Management Strategies for Patients Treated with Bisphosphonates
Prevention of BRONJ
Prior to treatment with monthly IV bisphosphonates, the patient should have a thorough oral
examination, any unsalvageable teeth should be removed, all invasive dental procedures should
be completed and optimal periodontal health should be achieved.
Three studies reported that preventative dental treatment decreased BRONJ risk among patients
with malignancy treated with IV bisphosphonates. 61-63 These findings suggest that, while
BRONJ is not eliminated, dental evaluations and treatment prior to initiating IV bisphosphonate
therapy among cancer patients reduces BRONJ risk.