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Bisphosphonate-associated osteonecrosis of the jaw: the rheumatologist's role

Franco Capsoni1*, Matteo Longhi1 and Roberto Weinstein2

Author Affiliations

1 Rheumatology Unit, Istituto Ortopedico Galeazzi IRCCS, University of Milan, Italy

2 Department of Odontology, Istituto Ortopedico Galeazzi IRCCS, University of Milan, Italy

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Arthritis Research & Therapy 2006, 8:219  doi:10.1186/ar2050

Published: 9 October 2006


Several recent reports have described osteonecrosis of the jaws (ONJ) associated with the use of bisphosphonates. Rheumatologists treating bone diseases with bisphosphonate need, therefore, to be aware of this potential risk and plan the prophylaxis, early diagnosis and prevention of potential consequences. We review the literature on this newly described complication, with particular focus on systemic and local predisposing pathologies, preventive measures suggested before and during therapy with bisphosphonates, and the most frequent clinical presentation of the oral lesions. The expert panel recommendations for the management of care of patients who develop ONJ are summarized.