title: Jaw osteonecrosis related to bisphosphonate treatment of bone metastasis.
abstract: The efficacy of bisphosphonate in controlling skeletally-related event in cancer patients without a great number of adverse events has resulted in a widespread use of these medications in oncology. Zoledronic acid and pamidronate are the most common bisphosphonates intravenously administered as a preventive treatment of bone complications encountered in multiple myeloma, as well as a palliative treatment of bone metastases in a large variety of solid tumours including breast, prostate and lung cancers. However, in recent years a relationship has been established between these drugs and a new bone injury characterised by avascular necrosis of bone that was isolated to the jaws. This paper reviews the literature concerning the discovery of this disease, its clinical, radiological and histological manifestations; its pathogenesis, with a look at the treatment and future options in preventing this complication and in treating hypercalcemia and bone lytic lesions in solid tumours.
authors.forename: L
authors.initials: L
authors.lastname: Raffaelli
authors.forename: L
authors.initials: L
authors.lastname: Scaramuzzo
authors.forename: P
authors.initials: P
authors.lastname: Rossi Iommetti
authors.forename: C
authors.initials: C
authors.lastname: Graci
authors.forename: G
authors.initials: G
authors.lastname: Maccauro
authors.forename: P F
authors.initials: PF
authors.lastname: Manicone
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000139:chemically induced* / Q000188:drug therapy; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000188:drug therapy; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000188:drug therapy; D000077268:Pamidronate; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D000077268:Pamidronate