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Table 1 Staging of bisphosphonate-related osteonecrosis of the jaw

From: Bisphosphonate-related osteonecrosis of the jaw in metastatic breast cancer patients: a review of 25 cases

Stages Description
At risk No apparent necrotic bone in patients who have been treated with either oral or intravenous bisphosphonates.
Stage 0 There is no clinical evidence of necrotic bone, but there are nonspecific clinical findings and symptoms such as swelling of the soft tissue and fistula formation.
Stage 1 There is exposed and necrotic bone or fistulas that probes to the bone in asymptomatic patients but there is no evidence of infection.
Stage 2 There is exposed and necrotic bone or fistulas that probes to the bone associated with infection as evidenced by pain and erythema in the region of exposed bone with or without purulent drainage.
Stage 3 There is exposed and necrotic bone or a fistula that probes to the bone with pain, infection, and one or more of the following: exposed and necrotic bone extending beyond the region of alveolar bone resulting in (1) pathologic fracture, (2) extraoral fistula, (3) oral-antral/oral-nasal communication, or (4) osteolysis extending to the inferior border of the mandible or sinus floor.