Osteonecrosis generally occurs due to cardiac insufficiency which leads to an interruption of the nutrient supply. Recently, osteonecrosis affecting only the jaw bones has been described as a unique complication connected to bisphosphonate therapy: Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ). There are still a lot of unknown factors involved in the management and treatment of patients taking bisphosphonates. Since 2003 reports of BRONJ were associated with intravenous and oral BP therapy for Paget’s disease and osteoporosis. BRONJ can occur spontaneously, due to dental disease or as a consequence of dental therapy. Old age, periodontitis, chronic corticosteroid therapy, prolonged use of bisphosphonates, smoking, and diabetes mellitus all may increase the risk of osteonecrosis. Expert panel recommendations for clinical decision making should also be balanced with the practitioner’s professional judgement and the individual patient’s needs
