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Associated Topics

Osteonecrosis of the jaws is associated with high-dose bisphosphonate treatment in patients with cancer.

James Zahrowski DMD, MS, PharmD .


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

Limited Evidence

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

Critical Summary Publication Date:


These summaries are not intended to, and do not, express, imply, or summarize standards of care, but rather provide a concise reference for dentists to aid in understanding and applying evidence from the referenced systematic review in making clinically sound decisions as guided by their clinical judgment and by patient needs. American Dental Association © 2019