Bisphosphonates and jaw osteonecrosis

Bisphosphonates have been widely prescribed for treatment of diseases characterized by intense bone resorption. These drugs have also been associated with a serious side effect, avascular osteonecrosis of the jaws. The authors present a literature review on bisphosphonates, focusing on their pharmacological features and their reported association with jaw osteonecrosis. The morbidity and lack of treatment response of this condition are serious facts to be considered when prescribing bisphosphonate therapy. The risk-benefit relationship needs to be seriously analyzed, and the treatment pros and cons should be explained to the patient. If the therapy with bisphosphonate is indicated, rigorous oral health adequacy must be performed and periodic evaluation of oral conditions is mandatory. At this moment, caution in treatment seems to be the best way to approach bisphosphonate users.