Which group of drugs has been linked to osteonecrosis of the jaw?

• A. Bisphosphonates
• B. Antibiotics
• C. Analgesics
• D. Antidepressants

Answer: (A)

Osteonecrosis of the jaw is most strongly linked to drugs that suppress bone turnover. Bisphosphonates do this by binding to bone and inhibiting osteoclast activity, which slows or halts bone remodeling. In the jaw, where bone turnover is high and healing after procedures is crucial, this can lead to the jawbone becoming exposed and necrotic, especially after dental extractions or other invasive work. The risk is particularly high with high-dose intravenous bisphosphonates used for cancer or metastasis, though oral forms can also pose a risk. Because of this clear connection, bisphosphonates are the group of drugs associated with osteonecrosis of the jaw. Other drug groups like antibiotics, analgesics, and antidepressants do not have a recognized strong link to ONJ.