Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev ET
ISSN: 1312-773X (Online)
Issue: 2017, vol. 23, issue 1
Subject Area: Dental Medicine - Oral and Maxillofacial surgery
DOI: 10.5272/jimab.2017231.1487
Published online: 14 March 2017

Case Report

J of IMAB 2017 Jan-Mar;23(1):1487-1489
Pavel Stanimirov1, 2ORCID logo, Corresponding Autor, Milena Petkova1ORCID logo,
1) Department of Oral and Maxillofacial surgery, Faculty of Dental medicine, Medical University Sofia, Bulgaria.
2) Department of Maxillofacial Surgery, University hospital Aleksandrovska, Sofia, Bulgaria.

Bisphosphonates (BPs) are the most widely used and effective anti-resorptive agents for the treatment of diseases in which there is an increase in osteoclastic resorption, including post-menopausal osteoporosis, Paget’s disease, and tumor-associated osteolysis.
Oral and maxillo-facial surgeons are well aware of the side effects of bisphosphonates and mainly with bisphosphonate-related osteonecrosis of the jaws (BRONJ). Less known are the mucosal lesions associated with the use of these agents. In the scientific literature there are only few reports of mucosal lesions due to the direct contact of the oral form of BPs with the mucosa (bisphosphonate-related mucositis). They are mostly related to improper use of bisphosphonate tablets that are chewed, sucked or allowed to melt in the mouth before swallowing. Lesions are atypical and need to be differentiated from other mucosal erosions.
We present a case of bisphosphonate-related mucositis due to the improper use of alendronate.

Key words: Bisphosphonates, bisphosphonate-related mucositis, mucosal ulceration,

- Download FULL TEXT /PDF 628 KB/
Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Stanimirov P, Petkova M. Bisphosphonate - related mucositis (BRM): a case report. J of IMAB. 2017 Jan-Mar;23(1):1487-1489. DOI: 10.5272/jimab.2017231.1487.

For correspondence: Pavel Stanimirov – Assoc. prof., Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University- Sofia; 1, St. Georgi Sofiiski str., 1431 Sofia, Bulgaria; E-mail:

1. De Ponte FS. Bisphosphonates and Osteonecrosis of the Jaw: A Multidisciplinary Approach. Italia, Springer; 2012; p.13-21
2. Yuan A, Woo SB. Adverse drug events in the oral cavity, Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Jan;119(1):35-47. [PubMed] [CrossRef]
3. Papapetrou  PD. Bisphosphonate-associated adverse events. Hormones (Athens). 2009 Apr-Jun;8(2):96-110. [PubMed]
4. Garcia-Font M, Curcó N, Prat C, Vives P. [Mouth sores caused by alendronate.] [in Spanish] Actas Dermosifiliogr. 2009 Jan-Feb;100(1):77-83. [PubMed]
5. Kharazmi M, Sjöqvist K, Warfvinge G. Oral ulcers, a little known adverse effect of alendronate: review of the literature. J Oral Maxillofac Surg. 2012 Apr;70(4):830-6. [PubMed] [CrossRef]
6. Ikebe T. Pathophysiology of BRONJ: Drug-related osteoclastic disease of the jaw. Oral Science International. 2013 Jan;10 (1):1–8. [CrossRef]
7. Krasagakis K, Kruger-Krasagakis S, Ioannidou D, Tosca A. Chronic erosive and ulcerative oral lesions caused by incorrect administration of alendronate. J Am Acad Dermatol. 2004 Apr;50(4):651-2. [PubMed] [CrossRef]
8. Andreadis D, Mauroudis S, Poulopoulos A, Markopoulos A, Epivatianos A. Lip ulceration associated with intravenous administration of zoledronic acid: report of a case. Head Neck Pathol. 2012 Jun;6(2):275–8. [PubMed] [CrossRef]
9. Jinbu Y, Demitsu T. Oral ulcerations due to drug medications. Jpn Dent Sci Rev. 2014 May;50(2):40-46. [CrossRef]
10. Deeming GM, Collingwood J, Pemberton MN. Methotrexate and oral ulceration. Br Dent J. 2005 Jan 22;198(2):83-5. [PubMed] [CrossRef].

Received: 19 October 2016
Published online: 14 March 2017

back to Online Journal