 However, osteoporosis is essentially the result of a lack of new bone formation in combination with bone resorption in reactive hyperemia, related to various causes and contributing factors, and bisphosphonates do not address these factors at all.In 2011, a proposal incorporating both the reduced bone turnover and the infectious elements of previous theories has been put forward.It cites the impaired functionality of affected macrophages as the dominant factor in the development of ONJ.