Treatment of bisphosphonates-associated osteonecrosis

This mini-review will focus on the management of a patient with bisphosphonate-associated osteonecrosis (BON). In order to review the subject the authors report a case of a patient with prostate cancer and metastatic bone disease who was treated with zoledronic acid. Prior to cancer the patient was treated with risedronate for osteopenia but had discontinued this treatment when cancer was diagnosed. During the description of each aspect of the case, a discussion of the rationale used for the case management is presented with support of the available literature. Aspects of interest include the diagnosis of BON, the risk factor for BON for this particular patient, the decision making process for the management of acute and long-term oral cavity problems, and the introduction of high intensity laser therapy to help control pain and reduce infection and local bacterial load.