Bisphosphonate-Associated Osteonecrosis of the Jaw: A Literature Review and Clinical Practice Guidelines (Report‪)‬

Introduction In May 2005 the drug company Novartis Pharmaceuticals Corporation sent a letter to dentists across the United States to warn them of reports of an adverse drug reaction (ADR), osteonecrosis of the jaw (ONJ), observed in cancer patients receiving treatment with intravenous (IV) bisphosphonates (BIS), Aredia (pamidronate disodium) and Zometa (zoledronic acid). Both drugs are manufactured by Novartis. The warning letter recommended that in dental patients who were being treated with these drugs "invasive dental procedures should be avoided if possible." (1) An additional recommendation was that cancer patients receive a dental examination prior to initiating therapy with IV administered bisphosphonates (Aredia, Zometa).