Osteonecrosis of the Jaw Related to Oral Bisphosphonate Treatment: A Clinical Case

Abstract

Bisphosphonates are inhibitors of osteoclastic activity and hence cause inhibition of
bone resorption.1-3 These drugs, which are synthetic analogy of natural pyrophosphate, have
proven their effectiveness in the treatment of diverse metabolic bone diseases related to quantitative
alterations, as is the case of osteoporosis,4-6 or qualitative ones, as in Paget’s disease.7
The most common way for their administration is orally.5 These anti-resorptive drugs cause an
increase of bone mineral density and a quick decrease of fracture risk.8-13 They are also effective
in oncology patients (breast cancer, prostate cancer, lung cancer, and multiple myeloma, among
others).14-19 Additionally, these medicines reduce the symptoms of bone pathology (bone pain,
delay of the first new bone event, reduction in fracture appearance).4,17-19 They are normally administered
intravenously. Bisphosphonates have anti-cancer effect alone or in combination with
other chemotherapy treatments, as they maximize antineoplastic effects.20 In pediatrics, they are
used in the treatment of diseases related to abnormal calcinosis or ectopic bone formation, as is
the case of osteogenesis imperfect.