A fluorescence-guided bone resection is a new method for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ). This technique was developed by Dr. Christoph Pautke.

Article Index
Bone necrosis
Page 2
Page 4
All Pages

Bone necrosis

If parts of the bone die off (Greek: necrosis), we speak of bone necrosis or osteonecrosis. There are various factors that may cause osteonecrosis in the jaw bones:

  • Infection
  • Irradiation (received during cancer treatment)
  • Medication (e.g. bisphosphonates, chemotherapeutic agents, cortisone, antibodies (angiogenesis inhibitors (bevacizumab, Avastin); against RANKL, denosumab))

In recent years, drug-associated necrosis of the jawbone caused by the regular intake of bisphosphonate preparations – therefore referred to as bisphosphonate-related osteonecrosis of the jaw (BRONJ) – has gained growing attention due to the rapid increase in the number of people affected by the condition.

Bisphosphonates are highly effective drugs with few side effects that inhibit bone resorption and remodelling. They are prescribed in their millions for treating osteoporosis (atrophy of the bone). They are used less frequently and at much higher concentration for the treatment of bone metastases in patients with malignant tumours (especially in breast cancer, prostate cancer and multiple myeloma). In 2003, however, a causal link was suspected for the first time between the regular intake of bisphosphonate preparations and the occurrence of bone necrosis of the jaw. 

In Germany, the bisphosphonates most frequently used include aledronic acid (e.g. Fosamax), zoledronic acid (e.g. Alcasta, Zometa), pamidronic acid (e.g. Aredia), ibandronic acid (Bondronat, Bonviva).

Medizin & Ästhetik | Alte Börse | Lenbachplatz 2a | 80333 München | Tel.: +49.89.51567963 | Email: