Bisphosphonate-Associated Osteonecrosis of the Jaw (BRONJ)

The Undersea and Hyperbaric Medical Society (UHMS) has approved hyperbaric oxygen therapy (HBOT) as a treatment for mandibular osteoradionecrosis (ORN,) otherwise known as delayed radiation injury to the jaw bone. Bisphosphonate-Associated Osteonecrosis of the Jaw (BRONJ,) is a side-effect of bisphosphonate drugs used to treat a variety of conditions including osteoporosis and multiple myeloma. Although the cause of the bone damage is not the same, the presentation is very similar. While HBOT is well documented and approved for treatment of ORN, the treatment of BRONJ is not yet approved. Early scientific research is pointing towards HBOT being a very effective treatment for BRONJ.

Cessation of bisphosphonate drugs alone does not seem to stop the condition from occurring, since they accumulate within bone with a high turnover rate, such as the maxilla (jaw.) The best treatment results seem to include HBOT as an adjunctive treatment to the standard approach accompanied by a cessation of the medication. 

Scientific References