Zoledronic Acid and Osteonecrosis of the Jaws 

Zoledronic acid administered once a year has been proven effective in the management of osteoporosis. Osteonecrosis of the jaws (ONJ) related to its use has not been reported since the drug was approved in 2007. A study by Jang-Jaer Lee, DDS, MS, et al published in Head Neck reported on 2 cases involving women with osteoporosis/osteopenia who developed ONJ after the second infusion of yearly zoledronic acid. The patients had no other systemic diseases and ONJ occurred after oral surgery procedures, which were performed about 2 months following administration of zoledronic acid. In the first case osteonecrosis of the maxilla resolved after conservative therapy and sequestrectomy. In the second case, bone necrosis developed on both sides of mandible, and the symptoms/signs of ONJ were partially responsive to conservative treatment. The authors conclude that ONJ related to yearly administration of zoledronic acid is a severe complication that should not be ignored. To minimize the risk, they recommend preventive oral care before the start of therapy and avoiding dental invasive procedures within 3 months after drug administration.
(Source: Head Neck, published online April 26, 2011, onlinelibrary.wiley.com/doi/10.1002/hed.21758/abstract)

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