An alternative to bisphosphonates

Bisphosphonates are a group of drugs that inhibit osteoclastic resorption of bone (osteoclasts are cells that resorb bone) and are used to treat a variety of bone-related conditions—mainly osteoporosis and metastatic bone disease (cancer that has spread into the bones). Bisphosphonates cause structural changes to the osteoclasts, which prevent bone resorption. They can be given orally (e.g. alendronate, etidronate, clodronate) or intravenously (e.g. zoledronate, pamidronate).

Bisphosphonate-induced osteonecrosis of the jaw (BONJ) is defined as ‘an area of exposed bone in the maxillofacial region that did not heal within 8 weeks after identification by a health care worker, in a patient who was receiving, or had been exposed to, a bisphosphonate and had not received radiation therapy to the craniofacial region’ (Arrain and Masud, 2009).