Bisphosphonate-related osteonecrosis of the jaws--a case report

Bisphosphonates are commonly prescribed for the treatment of osteoporosis and bone cancers. These drugs come in both intravenous and oral forms. Because these drugs have become more prevalent, there have been increased reports of bisphosphonate-related osteonecrosis of the jaws (BRONJ). This case presentation focuses on a 50-year-old woman with a 10-year history of monthly Zometa (zoledronic acid) use for treatment of multiple myeloma, resulting in BRONJ with a very unfavorable outcome. Its purpose is to depict how the chronic use of intravenous (i.v.) bisphosphonates can lead to bisphosphonate-related osteonecrosis of the jaw (BRONJ), and to present treatment options, including conservative measures, the dentist may be able to employ in the early phases of the disease, along with the indications for jaw resection. Osteonecrosis of the jaws in association with bisphosphonate therapy is a very serious condition with which all dentists should be familiar. When the osteonecrosis begins, it can be very painful to the patient, difficult to treat, and can lead to very deleterious sequelae.