What causes ONJ?
June 27, 2006 21:31

Bisphosphonates inhibit the production of osteoclasts. As a result, when the osteoclast can not soften the outer shell of the bone cell (the part of the bone that makes it hard), then there is no way for the new osteoblast cell to get into the boney structure to replace the dying mature osteoblast (osteocyte). When the mature cells die in the bone they can no longer maintain the Haversian canals and the blood flow through those opening ceases. The Haversion canals consist of a central hole surrounded by a number of concentric layers (rings) of bony tissue arranged concentrically around the central bone canal.

When the periosteal blood flow (blood within the bones) ends, then soft tissues around that bone and within the bone itself, which depend on that blood flow for health, also begin to die (or can not heal).

ONJ Resources
June 29, 2006 21:33

YOU: The Owner's Manual: An Insider's Guide to the Body that Will Make You Healthier and Younger, by Mehmet Oz, Michael F. Roizen. (Page 107). ISBN: 0060765313 - HarperCollins

FDA

E-Medicine

DRUG INFO

NIH

Gray's Anatomy.

J. Oral and Maxillofacial Surg. 63:1567-1575, 2005

JADA Vol 136 December 2005 1658-1669 & 1669-1675 & 1675-1682

J. Oral and Maxillofacial Surg. 2003: 61(9):1115-7

J. Oral and Maxillofacial Surg. 2004: 62(5):527-34

J. Oral and Maxillofacial Surg. 2005: 63(5):682-9

LIJ Doctors Link Common Chemotherapy Drug to Jawbone Necrosis. The LIJ press release can be seen in its entirety.

Ruggiero SL, Mehrotra B, Rosenberg TJ, et al: Osteonecrosis of the jaws associated with the use of bisphosphonates: A review of 63 cases. J Oral Maxillofac Surg 62:527-534, 2004

Marx RE: Pamidronate (Aredia) and zoledronate (Zometa) induced avascularnecrosis of the jaws: A growing epidemic. J Oral Maxillofac Surg 61:1115-1117, 2003

Factors to consider in screening for a Fosamax, Zometa or Actonel case
June 29, 2006 21:38

Factors to consider in potential clients using Bisphosphonates who develop jaw necrosis:1. Why the bisphosphonate was given?2. Was all dental work needed was done before the initiation of bisphosphonate therapy and that the plaintiff was carefully instructed... (Read Article)