Osteonecrosis of the jaw classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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## Classification[1][2]

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* Stage 0: Patients who present with unspecific symptoms or radiographic findings but without clinical evidence of necrosis.

* Symptoms:

* Dull pain in the mandible body which can radiate to the temporomandibular joint
* Unexplained odontalgia
* Maxillary sinus pain
* Altered mental status

* Clinical findings

* Not caries associated periapical or periodontal fistula
* Unexplained loosening of the teeth

* Radiographic findings

* Trabecular pattern changes

* Thickening of the periodontal ligament

* Osteosclerosis regions which involves alveolar bone and the basilar bone
* Alveolar bone loss or resorption

* Stage 1: Asymptomatic patients, without infection evidence who present an exposed necrotic bone or fistula. Radiographic findings mentioned above can be found in patients with stage 1
* Stage 2: Patients with exposed necrotic bone or fistula and signs of infection, usually symptomatic. Radiographic findings mentioned above can be found in patients with stage 2
* Stage 3: Patients with the characteristics of stage 2 plus one or more of the following conditions:

* Pathologic fracture
* Osteolisis which reaches the sinus floor or the external border of the mandible
* Orocutaneos fistula
* Comunication with the maxillary sinus (oroantral) or the nose (oronasal)

## References

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1. ↑ "http://www.aaoms.org/docs/position_papers/mronj_position_paper.pdf?pdf=MRONJ-Position-Paper" (PDF). External link in `|title=` (help)
2. ↑ Bedogni, A.; Fusco, V.; Agrillo, A.; Campisi, G. (2012). "Learning from experience. Proposal of a refined definition and staging system for bisphosphonate-related osteonecrosis of the jaw (BRONJ)". Oral Dis. 18 (6): 621–3. doi:10.1111/j.1601-0825.2012.01903.x. PMID 22353421. Unknown parameter `|month=` ignored (help)