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Bisphosphonates and avascular necrosis of the jaw: a possible association

Glen Carter, Alastair N Goss and Chris Doecke
Med J Aust 2005; 182 (8): 413-415.

In 2003, five patients presented to the Oral and Maxillofacial Surgery Unit at Royal Adelaide Hospital, South Australia, with painful exposed bone in the maxilla, or both the maxilla and mandible (Box 1 and Box 2 ).

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  • Glen Carter1
  • Alastair N Goss2
  • Chris Doecke3

  • 1 Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital and Adelaide Dental Hospital, SA.
  • 2 Royal Adelaide Hospital, Adelaide, SA.

Correspondence: 

  • 1. Assael LA. New Foundation in understanding osteonecrosis of the jaws. J Oral Maxillofac Surg 2004; 62: 125-126.
  • 2. Ruggiero S, Rosenberg TJ. Osteonecrosis of the jaws associated with the use of bisphosphonates. J Oral Maxillofac Surg 2004; 62: 527-534.
  • 3. Marx RE. Pamidronate (Aredia) and Zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic [letter]. J Oral Maxillofac Surg 2003; 61: 115-118.
  • 4. Wang J, Goodger NM, Pogrel MA. Osteonecrosis of the jaws associated with cancer chemotherapy. J Oral Maxillofac Surg 2003; 61: 1104-1107.
  • 5. Ashcroft AJ, Davies FE, Morgan GJ. Aetiology of bone disease and the role of bisphosphonates in multiple myeloma. Lancet Oncol 2003; 4: 284-292.
  • 6. Djulbegovic B, Whetley K, Ross J, et al. Bisphosphonates in multiple myeloma (Cochrane Review). Cochrane Database Syst Rev 2002 (3): CD003188.
  • 7. Luckman SP, Hughes DE, Coxon FP, et al. Heterocycle-containing bisphosphonates cause apoptosis and inhibit bone resorption by preventing protein prenylation: evidence from structure activity relationships in J774 macrophages. J Bone Miner Res 1998; 13: 1668-1678.
  • 8. Carter GD, Goss AN. Bisphosphonates and avascular necrosis of the jaws [letter]. Australian Prescriber 2004; 27: 32-33.
  • 9. Carter GD, Goss AN. Bisphosphonates and avascular necrosis of the jaws [letter]. Aust Dent J 2003; 48: 268.
  • 10. Adverse Drug Reactions Advisory Committee (ADRAC). Bisphosphonates and osteonecrosis of the jaw. Aust Adv Drug Reactions Bull 2005; 24: 3.

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