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J Am Dent Assoc, Vol 136, No 12, 1669-1674. © 2005 American Dental Association

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A review of current knowledge

Background. Increasing numbers of dental patients are taking bisphosphonate medications for a variety of indications. These drugs may be associated with poor healing, spontaneous intraoral ulceration and bone necrosis in the oral and maxillofacial region.

Case Description. The authors describe a case of osteonecrosis of the jaws in a patient receiving long-term bisphosphonate therapy for cancer. They offer recommendations for management and prevention of oral complications.

Conclusion and Clinical Implications. It is important that clinicians are aware of the association between bisphosphonate treatment and delayed wound healing and osteonecrosis of the jaws. They should consider referring patients in this population to specialists for even the most routine oral surgery. Clinicians should perform a thorough oral examination in patients before they begin any chemotherapy regimen.

Key Words: Bisphosphonates; osteonecrosis; oral surgery; mandible and maxilla; cancer metastasis; oral complications

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