OSTEONECROSIS FROM BISPHOSPHONATES
In osteonecrosis, bones are dying from lack of blood supply. Osteonecrosis can affect any bone in the body. The most common sites are the Hips, Knees, Shoulders and Ankles. Bisphosphonate therapy (mostly intravenous as in cancer-induced hypercalcemia) has been associated with osteonecrosis, primarily of the jaw. This has been observed mostly in cancer patients, but also in patients with postmenopausal osteoporosis. Risk factors include a diagnosis of cancer, chemotherapy, radiotherapy or corticosteroids; anemia, infection or pre-existing dental disease. Symptoms included nonhealing extraction socket or an exposed jawbone. Good dental hygiene can decrease the risk of osteonecrosis whereas stopping bisphosphonate therapy does not.