Osteonecrosis of the jaw after treatment with bisphosphonates

Is irreversible, so the focus must be on prevention

New generation bisphosphonates such as zolendronic acid, pamidronate, and alendronic acid have various indications in medicine. Initially, their use was restricted to patients with metastatic bone malignancy secondary to breast cancer, lung cancer, prostate cancer, or multiple myeloma. Their benefit in these conditions led to wider application for other bone pathologies, such as osteoporosis and Paget's disease.1 Their main effect is to inhibit osteoclast activity; however, they also seem to have antiangiogenic effects, …