title: New Non-Bisphosphonate Drugs that Produce Osteonecrosis of the Jaws.
abstract: OBJECTIVE
  The aim of this paper was to review the current literature associating the non-bisphosphonate cancer-treatment drugs Denosumab, Bevacizumab and Sunitinib (used with or without bisphosphonate [BP]) with the presence of osteonecrosis of the jaws (ONJ) in patients.
  
  
  METHODS
  A literature review was conducted using the keywords osteonecrosis of the jaws, oral biphosphosnates, Denosumab, Bevacizumab and Sunitinib. Articles were obtained that reported cases of ONJ associated with the use of Denosumab, Bevacizumab and Sunitinib.
  
  
  RESULTS
  The literature shows that Denosumab can cause ONJ associated with triggers such as microtraumas or dental extractions. The combination of the drug along with zoledronic acid may have a synergistic effect. Bevacizumab may cause ONJ; however, there is much controversy regarding its synergistic action when used with BP. Sunitinib causes ONJ, and together with BP could increase the risk of developing lesions.
  
  
  CONCLUSIONS
  Denosumab, Sunitinib or Bevacizumab are causal agents in the development of ONJ. The combination of any of these along with BPs could increase the risk of developing ONJ over that posed by BP treatment alone.
authors.forename: Lucía
authors.initials: L
authors.lastname: Ramírez
authors.forename: Rosa María
authors.initials: RM
authors.lastname: López-Pintor
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Casañas
authors.forename: Lorenzo de
authors.initials: Ld
authors.lastname: Arriba
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Hernández
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000068258:Bevacizumab / Q000009:adverse effects; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D000069448:Denosumab / Q000009:adverse effects; D006801:Humans; D007211:Indoles / Q000009:adverse effects; D007571:Jaw Diseases / Q000139:chemically induced*; D010020:Osteonecrosis / Q000139:chemically induced*; D011758:Pyrroles / Q000009:adverse effects; D000077210:Sunitinib
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D007211:Indoles; D011758:Pyrroles; D000068258:Bevacizumab; D000069448:Denosumab; D000077210:Sunitinib