Advances in the prevention and management of bisphosphonate-related osteonecrosis of the jaw: A literature review.

BACKGROUND: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) emerges as a serious side effect of bisphosphonate treatment worldwide, significantly impairing patients' oral health and overall quality of life. Ongoing research shows emerging treatment modalities such as a combination of pentoxifylline and tocopherol, teriparatide, and platelet concentrates that enhances the prospects of BRONJ treatment. However, the need for more accurate and predictable treatment options still remains. The aim of this review is to summarize and ascertain the current prevention and treatment strategies of BRONJ. MATERIALS AND METHODS: A narrative literature review was conducted using the PubMed, Wiley Online Library, ScienceDirect, and Springer databases using the Medical Subject Headings (MeSH) terms including "Osteonecrosis of the Jaw," "Disphosphonates," "Teriparatide," "Platelet-Rich Plasma," and "Pentoxifylline". Inclusion criteria comprised clinical studies involving human subjects that evaluated prevention or treatment strategies for bisphosphonate-related osteonecrosis of the jaw. Randomized controlled trials, prospective and retrospective cohort studies, and clinical comparative studies published in English between 2015 and 2025. The literature search was conducted in January 2025. RESULTS: Emerging prevention and treatment strategies, including teriparatide and the combination of pentoxifylline and tocopherol, show potential in improving clinical outcomes and reducing disease progression. CONCLUSIONS: Although emerging treatment methods show promising results, BRONJ continues to pose significant clinical challenges.