Post biphosphonate mandible osteonecrosis: A case study and literature review

Bisphosphonates have proven effective in reducing pain and skeletal events in bone metastases treatment. However, there is a long-term complication called osteonecrosis of the jaw, which has been reported for more than a decade. Despite various professional recommendations, there is no international consensus on the best therapeutic strategy. Prevention is crucial, and a multidisciplinary approach must be tailored to each stage of the condition. We present a case of osteonecrosis of the jaw in a patient with metastatic breast cancer who was receiving 4 mg injectable zoledronic acid. The patient stopped treatment with zoledronic acid and received systemic treatment (analgesics, antibiotics), with the resolution of symptoms. ONJ is a serious condition associated with taking BP that can impact oral health and quality of life. Our study highlights the effectiveness of systematic treatment in managing ONJ with BP-related alterations. Preventative measures, such as regular dental consultations, play a vital role in reducing the risk of ONJ. Multidisciplinary management is essential to addressing the different stages of the condition. •Bisphosphonates (BP) reduce pain and skeletal events in bone metastasis treatment.•Osteonecrosis of the jaw (ONJ) is a long-term complication associated with BP use.•There is no international consensus on the best therapeutic strategy for ONJ.•Prevention is crucial, a multidisciplinary approach is needed for each stage.•Systematic treatment, discontinuating bisphosphonates, and therapy can manage osteonecrosis, resolving symptoms.