Drug induced osteonecrosis of the upper and lower jaw

Antiresorptive osteonecrosis (ARON) of the upper and lower jaw is a more frequent and feared complication of the antiresorptive treatment in patients with osteoporosis, hypercalcaemia and bone metastases involving a skeleton with cancer. At present, there are new anti-resorptive drugs available, such as monoclonal antibodies, the use of which should lead to a reduction of manifestation of bone complications and side effects. Recently, osteonecrosis has also been described in the treatment of antiangiogenic-cytostatic and hormonal therapy, without use of any previous biphosphonate preparations and monoclonal antibodies. Known risk factors of ARON formation include: effectiveness of the administered drug, way of administration, dose accumulation, associated comorbidities and the general state of the patient. This study shows patients displaying ARON and identifies possible causes, preventive measures and treatment strategies. (author)