title: Osteonecrosis of the jaws associated with the use of yearly zoledronic acid: report of 2 cases.
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.
authors.affiliation: Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jang-Jaer
authors.initials: JJ
authors.lastname: Lee
authors.forename: Shih-Jung
authors.initials: SJ
authors.lastname: Cheng
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Wang
authors.forename: Jiiang-Huei
authors.initials: JH
authors.lastname: Jeng
authors.forename: Chun-Pin
authors.initials: CP
authors.lastname: Chiang
authors.forename: Sang-Heng
authors.initials: SH
authors.lastname: Kok
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D008334:Mandible / Q000473:pathology* / Q000601:surgery; D008437:Maxilla / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid