Osteonecrosis of the jaws in patients treated with bisphosphonates.  Review of the literature and the Milan experience. 
A series of 5 patients with osteonecrosis of the jaws possibly related to the use of bisphosphonates is presented.  A brief review of the literature is also proposed.  A retrospective review of patients who received bisphosphonates and who developed osteonecrosis of the jaws following minor oral surgery was performed.  In all 5 patients, a tooth extraction preceded the onset of osteonecrosis of the mandible.  Patients were on chronic use of intravenous bisphosphonates.  The presenting lesions was a nonhealing extraction socket and an exposed jawbone.  Biopsy of the bone lesions showed no evidence of metastatic involvement.  Antibiotic therapy, conservative debridement and, in some cases, bone sequestrectomy were performed.  Osteonecrosis of the jaws appears to have a relationship with the use of bisphosphonates.  It is important that medical oncologists and dentists become aware of this possible complication in order to perform minor oral surgery prior to starting bisphosphonates treatment.