Bisphosphonates are widely prescribed as treatments for osteoporosis and other bone disorders. Approximately 3% of patients develop osteonecrosis of the jaws (ONJ) with exposed bone and pain. Patients with IV administration are more likely to develop ONJ but because the persistence of the drugs in the bone are about 10 years, it is possible that we have a silent epidemic developing in the patients who had had oral medication. The radiographic appearance is variable with increased periodontal ligament spaces, thickened lamina dura, sclerotic bone and even sequestra like osteomyelitis.
The panoramic in A is normal and one year later in B shows extensive sclerosis and sequestrum formation. Click here to view: BISPHOSPHONATE_OSTEONECROSIS_Jaws