Osteonecrosis of the jaw: more heat than light.

Osteonecrosis of the jaw has received a great deal of attention in the past few years. The earliest case reports claimed that the only time it ever occurred was as a complication of therapy with bisphosphonates and that both oral and intravenous bisphosphonates were implicated (1). These reports led to use of terms such as BRONJ (bisphosphonate-related osteonecrosis of the jaw). The speculation about pathogenic mechanisms, including any relationship with bisphosphonate therapy, has shifted in emphasis over time, starting with the notion that the mechanism might be a form of avascular necrosis of bone and more recently emphasizing the importance of