Bisphosphonates and osteonecrosis of the jaw: innocent association or significant risk?

Published case series and systematic reviews have documented an association between bisphosphonates and osteonecrosis of the jaw. However, a cause-and-effect relationship has not been established, and most of the reported cases have been in patients with cancer who were receiving much higher doses than those used to treat osteoporosis or Paget disease of bone. The risk, if any, to patients with these latter conditions receiving these drugs appears to be very small.