Journal Top Ten, Columns-Drugs & Supplements, May 2006

ARTICLE: 'Systematic review: bisphosphonates and osteonecrosis of the jaws.

JOURNAL: Annals of Internal Medicine. 2006 May 16;144(10):753-61.

SUMMARY: Osteonecrosis of the jaws is a recently described adverse side effect of bisphosphonate therapy. Patients with multiple myeloma and metastatic carcinoma to the skeleton who are receiving intravenous, nitrogen-containing bisphosphonates are at greatest risk for osteonecrosis of the jaws; these patients represent 94% of published cases. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60% of cases are preceded by a dental surgical procedure. Oversuppression of bone turnover …