[Drug-induced osteonecrosis of the jaw - not just bisphosphonates].

Metastatic bone disease and osteoporosis have a large impact on quality of life and are associated with the development of skeletal-related events (SREs), such as fractures and spinal cord compression. Pharmacologic managing of metastatic bone disease and osteoporosis typically involves antiresorptive agents such as bisphosphonates and RANKL inhibitors. Undesired adverse effects resulting from the use of these drugs include osteonecrosis of the jaw (ONJ). Dentoalveolar surgery, particularly tooth extraction, appears to increase the risk of ONJ. However, spontaneous events were also documented. Therefore, it is of upmost importance for the general practitioner to have updated knowledge in order to prevent and early diagnose ONJ. We present a case of a metastatic breast cancer patient who spontaneously developed ONJ following the use of Denosumab, a monoclonal RANKL antibody.