{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:54:48Z","timestamp":1792598088440,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,12,26]],"date-time":"2012-12-26T00:00:00Z","timestamp":1356480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Oral Implants Res"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Bisphosphonate\u2010related jaw necrosis (<jats:styled-content style=\"fixed-case\">BRONJ<\/jats:styled-content>) associated with dental implants is a rare but continuously reported complication. To verify clinical and pathological characteristics of <jats:styled-content style=\"fixed-case\">BRONJ<\/jats:styled-content> around dental implants, the present study analyzed clinical, radiographic and histopathological findings of these lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Nineteen patients were diagnosed with osteonecrosis of the jaw associated with dental implants and treated at our institute from 2008 to 2011. The patients' medical history, demographic features, radiographic, and histopathological findings along with information on bisphosphonates (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>) administration were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of <jats:styled-content style=\"fixed-case\">BRONJ<\/jats:styled-content> patients associated with dental implants used oral <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> for osteoporosis. The patients were divided into two groups: <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> initiation before (<jats:italic>n<\/jats:italic>\u00a0=\u00a016) and after (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) implant surgery. Only three patients (15.8%) could be regarded as \u201cimplant surgery\u2010triggered\u201d <jats:styled-content style=\"fixed-case\">BRONJ<\/jats:styled-content>. Many patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a09) showed successful osteointegration after fixture installation to an average of 35\u00a0months (11\u201382\u00a0months) until the development of osteonecrosis. The histological features of the lesion showed that the necrotic bone with empty lacunae was infiltrated by inflammatory cells and bacterial colonies. Viable osteocytes were also observed in some areas of the bony specimens. Three types of bone destruction pattern were observed: (i) complete necrosis of the bone around the implant (frozen type), (ii) extensive osteolysis around the implant with or without sequestra (osteolytic type), and (iii) sequestration of bone with an implant maintaining direct implant\u2013bone contact (en block sequestration type). These findings could be existed at the same lesions depending on the degree of local bone destruction and the severity of the infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results and those of others suggested that already osseointegrated dental implants can also cause the osteonecrosis around the implant after <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> administration. En block sequestration of bone with implant might be one of the characteristics of implant\u2010related <jats:styled-content style=\"fixed-case\">BRONJ<\/jats:styled-content>, which is different from peri\u2010implantitis\u2010induced bone destruction. The possible role of microcracks in this type of bone destruction needs to be examined further.<\/jats:p><\/jats:sec>","DOI":"10.1111\/clr.12088","type":"journal-article","created":{"date-parts":[[2012,12,27]],"date-time":"2012-12-27T02:49:30Z","timestamp":1356576570000},"page":"632-640","source":"Crossref","is-referenced-by-count":102,"title":["Osteonecrosis associated with dental implants in patients undergoing bisphosphonate treatment"],"prefix":"10.1111","volume":"25","author":[{"given":"Tae\u2010Geon","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Oral &amp; Maxillofacial Surgery School of Dentistry Kyungpook National University Daegu Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010O","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Oral &amp; Maxillofacial Surgery School of Dentistry Kyungpook National University Daegu 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