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

Authors

  • Jang-Jaer Lee DDS, MS,

    1. Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    2. Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Shih-Jung Cheng DDS, MS,

    1. Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    2. Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Yi-Ping Wang DDS, MS,

    1. Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    2. Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Jiiang-Huei Jeng DDS, PhD,

    1. Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Chun-Pin Chiang DDS, PhD,

    1. Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
    Search for more papers by this author
  • Sang-Heng Kok DDS, PhD

    Corresponding author
    1. Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    2. Department of Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
    Search for more papers by this author

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. © 2011 Wiley Periodicals, Inc. Head Neck, 2013

Ancillary