Risk category No clinical/radiological evidence of exposed bone or infection/inflammation.
Treatment plan No surgical treatment is needed. Patient has to be informed about following risks. Good oral hygiene with re-examinations at least once every 6 months should be done.
Stage I Clinical evidence of exposed bone for more than 8 weeks. This stage is usually asymptomatic. No signs infection is normally seen.
Treatment plan No surgical treatment is needed. Antibacterial mouth rinses, professional oral hygiene with no injury of exposed bone can be considered, common follow-ups for exposed bone re-evaluation. Antibiotic treatment can be prescribed if patients condition is difficult.
Stage II Exposed/ necrotic bone with signs of infection, drainage of inflammatory matter can appear.
Treatment plan Management of pain, broad-spectrum antibiotics, antibacterial mouthrinses, debridement of necrotic bone surface area, common follow-ups with professional oral hygiene and re-evaluation of necrotic bone. Drug holidays may be considered as an option.
Stage III Exposed/ necrotic bone with sings of infection. Extraoral fistula, pathological fractures can appear.
Treatment plan Antibacterial mouthrinses and broad spectrum antibiotics with pain management to prepare patient for surgical intervention-resection of necrotic bone. Drug holidays may be considered as an option.

aStages applies for patients, who used or are using intraoral/intravenous bisphosphonates, and had no history of radiotherapy of head/neck.