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Osteonecrosis of the jaw and bisphosphonates

BMJ 2006; 333 doi: (Published 23 November 2006) Cite this as: BMJ 2006;333:1122

Editorial was confusing

  1. Mark J Bolland (,
  2. Andrew Grey, associate professor of medicine,
  3. Ian R Reid, professor of medicine
  1. 1Department of Medicine, University of Auckland, Auckland, New Zealand

    The recent editorial by Landis et al has added confusion rather than clarity to the issue of osteonecrosis of the jaw (ONJ) in association with the use of bisphosphonates.1 They do not distinguish between the use of very high doses of intravenous bisphosphonates (monthly pamidronate or zoledronate) to treat patients with malignancy, and the use of much lower doses of bisphosphonates (approximately 1/12 of the oncology dose) in the treatment of Paget's disease or osteoporosis. These two different uses of bisphosphonates have been associated with different risks …

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