Intravenous bisphosphonate-associated osteonecrosis of the jaw

Thomas A. Statz, Janet M. Guthmiller, Lewis A. Humbert, Georgia K. Johnson

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Bisphosphonates have received attention in the dental and medical scientific literature because of spontaneous necrosis of the jaw subsequent to their use. As the population ages, the use of these medications is increasing; the medical benefits seem to outweigh the risk for osteonecrosis of the jaw (ONJ). Methods: A 71-year-old white male with a history of multiple myeloma, for which he was receiving intravenous (IV) zoledronic acid, presented for routine periodontal maintenance therapy. Intraoral observation revealed a 9 x 4-mm area of exposed bone on the lingual aspect of tooth #31. Initially, the site was treated conservatively with topical 0.12% chlorhexidine gluconate application. Over a 12-month period, the area of exposed bone increased in size to 20 x 9 mm and became symptomatic. Results: The osseous necrosis progressed, ultimately resulting in a pathologic fracture of the right posterior mandible that was managed by reduction and stabilization. At 5 months post-surgery, bone exposure persisted in the region, and a new site of osteonecrosis developed on the contralateral side of the jaw. Conclusions: ONJ associated with IV bisphosphonate therapy is extremely difficult to manage. Dental treatment of ONJ should be conservative and provide relief to the patient. Patients with cancer who are candidates for IV bisphosphonate therapy should be informed of the potential risks and be referred for dental evaluation. Dentists should collaborate with physicians to minimize the risk for ONJ.

Original languageEnglish (US)
Pages (from-to)2203-2208
Number of pages6
JournalJournal of periodontology
Volume78
Issue number11
DOIs
StatePublished - Nov 1 2007

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Bisphosphonate-Associated Osteonecrosis of the Jaw
Jaw
Osteonecrosis
Tooth
Diphosphonates
zoledronic acid
Necrosis
Hyoid Bone
Literature
Bone and Bones
Spontaneous Fractures
Therapeutics
Dentists
Multiple Myeloma
Mandible
Observation
Physicians
Population

Keywords

  • Bisphosphonates
  • Multiple myeloma
  • Osteonecrosis

ASJC Scopus subject areas

  • Periodontics

Cite this

Intravenous bisphosphonate-associated osteonecrosis of the jaw. / Statz, Thomas A.; Guthmiller, Janet M.; Humbert, Lewis A.; Johnson, Georgia K.

In: Journal of periodontology, Vol. 78, No. 11, 01.11.2007, p. 2203-2208.

Research output: Contribution to journalArticle

Statz, Thomas A. ; Guthmiller, Janet M. ; Humbert, Lewis A. ; Johnson, Georgia K. / Intravenous bisphosphonate-associated osteonecrosis of the jaw. In: Journal of periodontology. 2007 ; Vol. 78, No. 11. pp. 2203-2208.
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