Bisphosphonate-associated osteonecrosis

a long-term complication of bisphosphonate treatment

Cesar A. Migliorati, Michael A. Siegel, Linda S. Elting

Research output: Contribution to journalArticle

259 Citations (Scopus)

Abstract

We present current knowledge of bisphosphonate-associated osteonecrosis, a new oral complication in oncology. It was first described in 2003, and hundreds of cases have been reported worldwide. The disorder affects patients with cancer on bisphosphonate treatment for multiple myeloma or bone metastasis from breast, prostate, or lung cancer. Bisphosphonate-associated osteonecrosis is characterised by the unexpected appearance of necrotic bone in the oral cavity. Osteonecrosis can develop spontaneously or after an invasive surgical procedure such as dental extraction. Patients might have severe pain or be asymptomatic. Symptoms can mimic routine dental problems such as decay or periodontal disease. Intravenous use of pamidronate and zoledronic acid is associated with most cases. Other risk factors include duration of bisphosphonate treatment (ie, 36 months and longer), old age in patients with multiple myeloma, and a history of recent dental extraction. We also discuss pathobiology, clinical features, management, and future directions for the disorder.

Original languageEnglish (US)
Pages (from-to)508-514
Number of pages7
JournalLancet Oncology
Volume7
Issue number6
DOIs
StatePublished - Jun 1 2006

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Bisphosphonate-Associated Osteonecrosis of the Jaw
Diphosphonates
Tooth Extraction
pamidronate
zoledronic acid
Multiple Myeloma
Bone and Bones
Osteonecrosis
Periodontal Diseases
Mouth
Lung Neoplasms
Prostatic Neoplasms
Tooth
Therapeutics
Breast Neoplasms
Neoplasm Metastasis
Pain
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Bisphosphonate-associated osteonecrosis : a long-term complication of bisphosphonate treatment. / Migliorati, Cesar A.; Siegel, Michael A.; Elting, Linda S.

In: Lancet Oncology, Vol. 7, No. 6, 01.06.2006, p. 508-514.

Research output: Contribution to journalArticle

Migliorati, Cesar A. ; Siegel, Michael A. ; Elting, Linda S. / Bisphosphonate-associated osteonecrosis : a long-term complication of bisphosphonate treatment. In: Lancet Oncology. 2006 ; Vol. 7, No. 6. pp. 508-514.
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