1. Bisphosphonate treatment: An orthodontic concern calling for a proactive approach 
James J. Zahrowski 
American Journal of Orthodontics and Dentofacial Orthopedics 
Volume 131, Issue 3, Pages (March 2007)
DOI: /j.ajodo
Copyright © 2007 American Association of Orthodontists Terms and Conditions

2. Fig l
After long-term IV administration of pamidronate and zolendronic acid for multiple myeloma, tooth pain and infection resulted in extractions in mandibular left quadrant. Osteonecrosis presented with loss of alveolar bone. Grafting procedures are not expected to be successful. Several root canals were unsuccessful in resolving pain (radiograph courtesy of Sanford Ratner).
American Journal of Orthodontics and Dentofacial Orthopedics  , DOI: ( /j.ajodo )
Copyright © 2007 American Association of Orthodontists Terms and Conditions

3. Fig 2
A, After 2 years of IV zoledronic acid for treatment of multiple myeloma, tooth infection required extractions in mandibular right quadrant. B, Osteonecrosis was found, and excessive alveolar bone loss continued postextraction. Spontaneous fracture of mandible occurred. No normal healing of fracture site was observed, and mandible will be stabilized with titanium frame (radiographs courtesy of Sanford Ratner).
American Journal of Orthodontics and Dentofacial Orthopedics  , DOI: ( /j.ajodo )
Copyright © 2007 American Association of Orthodontists Terms and Conditions

4. Fig 3
A, After 4 years of IV zoledronic acid treatment for multiple myeloma, right mandibular first molar was extracted due to abscess that did not respond to treatment (patient had existing stable implants with nonideal placement in mandibular right quadrant). B, Osteonecrosis was observed, and serious bone infection required block resection of alveolar bone. Infection was controlled, but bone remained exposed. No bone or soft-tissue grafting procedures were done (radiographs courtesy of Sanford Ratner).
American Journal of Orthodontics and Dentofacial Orthopedics  , DOI: ( /j.ajodo )
Copyright © 2007 American Association of Orthodontists Terms and Conditions