Bisphosphonate-related osteonecrosis of the jaw: the role of actinomyces.

The etiology of bisphosphonate-related osteonecrosis of the jaw is unknown but was initially postulated to be mediated by bisphosphonate accumulation within the jaws, resulting in avascular necrosis. Bisphosphonates may not be the primary cause. Actinomyces are an underrecognized agent in pathogenesis, and timely actinomycosis-specific treatment may improve outcome.