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Once-yearly zoledronic acid has been proven effective in the management of osteoporosis. Osteonecrosis of the jaws (ONJ) related to its use has not been reported since its approval in 2007. Two women with osteoporosis/osteopenia developed ONJ after the second infusion of yearly zoledronic acid. They had no other systemic diseases and ONJ occurred after oral surgeries, which were performed about 2 months following drug administration. In 1 case osteonecrosis of the maxilla resolved after conservative therapy and sequestrectomy. In the other case bone necrosis developed on both sides of mandible, and the symptoms/signs of ONJ were partially responsive to conservative treatment. ONJ related to yearly zoledronic acid is a severe complication that should not be ignored. To minimize the risk, we recommend preventive oral care before the start of therapy and avoiding dental invasive procedures within 3 months after drug administration. Copyright © 2011 Wiley Periodicals, Inc.


Jang-Jaer Lee, Shih-Jung Cheng, Yi-Ping Wang, Jiiang-Huei Jeng, Chun-Pin Chiang, Sang-Heng Kok. Osteonecrosis of the jaws associated with the use of yearly zoledronic acid: report of 2 cases. Head & neck. 2013 Jan;35(1):E6-10

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PMID: 21523843

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