Table 1.

Clinical staging of BRONJ and treatment guidelines^a

Stages	Treatments guidelines
At risk category: no apparent exposed/necrotic bone in patients treated with either oral or iv bisphosphonates	No treatment indicated
	Patients education
Stage 1: exposed/necrotic bone in patients who are asymptomatic and have no evidence of infection	Antibacterial mouth rinse
	Clinical follow-up every 4 months
Stage 2: exposed/necrotic bone associated with infection. Presence of pain and erythema in the lesional area with or without purulent drainage	Treatment with broad-spectrum oral antibioticsb
	Antibacterial mouth rinse
	Pain control
	Superficial debridement to relieve soft tissue irritation
Stage 3: exposed/necrotic bone in patients with infection and pain. Presence of one or more of the following: pathologic fractures, extraoral fistula, or osteolysis extending to the inferior border	Antibacterial mouth rinse
	Antibiotic therapy and pain control
	Surgical debridement/resection for longer term palliation of infection and pain

^aModified from Ref. [53]

^bPenicillin, amoxicillin/clavulanate potassium, metronidazole, cephalexin, clindamycin, fluoroquinolone