Osteonecrosis of the jaws is associated with high-dose bisphosphonate treatment in patients with cancer. Critical Summary Prepared by: James Zahrowski DMD, MS, PharmD 

A Critical Summary of:

Bisphosphonate associated osteonecrosis of the jaw

Khan AA, Sandor GK, Dore E, Morrison AD, Alsahli M, Amin F, Peters E, Hanley DA, Chaudry SR, Lentle B, Dempster DW, Glorieux FH, Neville AJ, Talwar RM, Clokie CM. Journal of Rheumatology. 2009;36(3):478-90

Published Date: 7/17/2010

This summary is published in the Journal of the American Dental Association and can be accessed at :-


  • Systematic Review Conclusion:

    Osteonecrosis of the jaws (ONJ) is associated with high-dose and duration of bisphosphonate (BP) treatment in patients with cancer but there is insufficient evidence to link low-dose BP therapy with ONJ in patients with osteoporosis.

  • Critical Summary Assessment:

    Although this systematic review suggested that ONJ is linked only to high-dose BP treatment in patients with cancer, studies published after this review have reported low incidences of ONJ during low-dose BP therapy in patients with osteoporosis, which warrants vigilance.

  • Evidence Quality Rating:


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