Osteonecrosis of the jaws associated with the use of yearly zoledronic acid: report of 2 cases

Head Neck. 2013 Jan;35(1):E6-10. doi: 10.1002/hed.21758. Epub 2011 Apr 26.

Abstract

Background: Once-yearly zoledronic acid has been proven effective in the management of osteoporosis. Osteonecrosis of the jaws (ONJ) related to its use has not been reported since its approval in 2007.

Methods: Two women with osteoporosis/osteopenia developed ONJ after the second infusion of yearly zoledronic acid. They had no other systemic diseases and ONJ occurred after oral surgeries, which were performed about 2 months following drug administration.

Results: In 1 case osteonecrosis of the maxilla resolved after conservative therapy and sequestrectomy. In the other case bone necrosis developed on both sides of mandible, and the symptoms/signs of ONJ were partially responsive to conservative treatment.

Conclusions: ONJ related to yearly zoledronic acid is a severe complication that should not be ignored. To minimize the risk, we recommend preventive oral care before the start of therapy and avoiding dental invasive procedures within 3 months after drug administration.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / diagnosis*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / drug therapy
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / surgery
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / adverse effects*
  • Diphosphonates / administration & dosage
  • Diphosphonates / adverse effects*
  • Female
  • Humans
  • Imidazoles / administration & dosage
  • Imidazoles / adverse effects*
  • Mandible / pathology*
  • Mandible / surgery
  • Maxilla / pathology*
  • Maxilla / surgery
  • Middle Aged
  • Osteoporosis / drug therapy
  • Zoledronic Acid

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Zoledronic Acid