Bisphosphonate-associated osteonecrosis of the jaws. Report of a case and literature review

This paper reviews the main aspects involved in the bisphosphonate-associated osteonecrosis of the jaws and report its occurrence in a 82-year-old man, who had received long-term treatment with zoledronate to manage bone metastases due to prostate cancer. The clinical aspects and the treatment are presented. Computerized tomography contributed to a more specific diagnosis, demonstrating the osteonecrosis in the maxilla, sinus involvement, and sclerotic areas in the entire body of the mandible and c-spine. Clinical trials and studies in animals are necessary to elucidate the pathogenesis of bisphosphonate-associated osteonecrosis of the jaws, and to determine whether the bisphosphonates produce sclerotic changes in the skeleton similar to those found in osteopetrosis. Nevertheless, patients taking bisphosphonates should receive prophylactic attention to maintain their oral health. Preventive measures must be taken before, during, and after treatment with bisphosphonates.