Bisphosphonates is a group of inorganic pyrophosphates analogues that suppress bone resorption by
inducing osteoclast inactivation, being frequently used for management of diseases affecting bone
metabolism, bone metastases and bone tumors. However, since 2003 many cases describing the presence
of necrotic bone exposures in the jaws have been described in patients receiving these drugs, what
represent a significant complication of bisphosphonates treatment. The overall incidence of
bisphosphonate-related osteonecrosis of the jaws is low, ranging from 0.7% to 12%, mainly observed
in those patients receiving intravenously treatment. Osteonecrosis of the jaws associated to oral
bisphosphonate, particularly alendronate, has also been reported by a number of authors. Considering
that alendronate is one of the most used drugs worldwide, specially for treatment of osteoporosis, a
better understanding of osteonecrosis of the jaws related to its use and how to manage these
patients is extremely important. Therefore, in the current manuscript the authors aim to review the
most important topics related to this pathological presentation.
Key words:Bisphosphonates, alendronate, bisphosphonate-related osteonecrosis of the
jaws, osteonecrosis.