Bisphosphonates and osteonecrosis of the jaw

• 13 cases of osteonecrosis of the jaw associated with bisphosphonate use have recently been reported to the Adverse Drug Reactions Advisory Committee. • Most cases were associated with intravenous bisphosphonate therapy (11 cases with zoledronic acid and one with pamidronate), but one was associated with oral alendronate used to treat osteoporosis. • The condition causes chronic pain, dysfunction and disfigurement; no treatment has proven consistently effective, and withdrawing the bisphosphonate does not seem to hasten recovery. • The focus should be on prevention through attending to any necessary dental treatment before bisphosphonate therapy begins.