Bisphosphonate-Related Osteonecrosis of the Jaws: A Single-Center Study of 101 Patients

Towy Sorel Lazarovici, Ran Yahalom, Shlomo Taicher, Sharon Elad, Izhar Hardan, Noam Yarom*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

136 Scopus citations


Purpose: Osteonecrosis of the jaw (ONJ) is a devastating side effect of long-term bisphosphonate (BP) use. We present the largest case series from a single department. Materials and Methods: This case series included 101 ONJ patients. Data on demographics, medical background, type and duration of BP use, possible triggering events, mode of therapy, and outcome were recorded. Results: ONJ was associated with intravenous BPs in 85 patients and with oral BPs in 16 patients. It was diagnosed after 48, 27, and 67 months of pamidronate, zoledronic acid, and alendronate use, respectively. Long-term antibiotics and minimal surgical procedures resulted in complete or partial healing in 18% and 52% of the patients, respectively; 30% had no response. There was no association between ONJ and diabetes, steroid and antiangiogenic treatment, or underlying periodontal disease. Diagnostic biopsies aggravated lesions without being informative about pathogenesis. A conservative regimen is our treatment of choice. Conclusion: Solutions for decreasing morbidity and poor outcome of ONJ remain elusive.

Original languageEnglish
Pages (from-to)850-855
Number of pages6
JournalJournal of Oral and Maxillofacial Surgery
Issue number4
StatePublished - Apr 2009
Externally publishedYes


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