Bisphosphonate-Related Osteonecrosis of the Jaw Mimicking Bone Metastasis

Table 1

AAOMS staging system of BRONJ.

Stage	Clinical findings	Treatment recommendations
Stage 0	(i) Nonspecific; (ii) No clinical evidence of necrotic bone	Systemic management, including pain medication and antibiotics
Stage I	Exposed, necrotic bone	(i) Antibacterial mouth rinse; (ii) Follow-up on a quarterly basis patient education
Stage II	(i) Painful; (ii) Exposed necrotic bone; (iii) Infection of the wound cavity	(i) Oral antibiotics; (ii) Oral antibacterial mouth rinse, pain control; (iii) Superficial debridement to relieve soft tissue irritation
Stage III	(i) Painful; (ii) Exposed, necrotic bone; (iii) Wound infection; (iv) Pathologic fracture/oral cutaneous fistula/osteolysis extending to the inferior border of the mandible	(i) Antibacterial mouth rinse; (ii) Antibiotic therapy; (iii) Pain control; (iv) Surgical debridement/resection for longer-term palliation of infection and pain