Risks of bisphosphonate therapy
Oral and maxillofacial surgeons first recognized and reported cases of non-healing exposed bone
in the maxillofacial region in patients treated with IV bisphosphonates. 23-24 Since these initial
reports, several case series and reviews have been published. 25-32 In September 2004, Novartis,
the manufacturer of the IV bisphosphonates pamidronate (Aredia® ) and zoledronic acid
(Zometa®), notified healthcare professionals of additions to the labeling of these products, which
provided cautionary language related to the development of osteonecrosis of the jaws. 33 This
was followed in 2005 by a broader drug class warning of this complication for all
bisphosphonates including the oral preparations. 34-35 See Appendix 1 for list of bisphosphonate
medications that are currently available in the United States.