Purpose: The aim of this paper was to review the current literature associating the non-bisphosphonate cancer-treatment
drugs Denosumab, Bevacizumab and Sunitinib (used with or without bisphosphonate [BP]) with the presence of
osteonecrosis of the jaws (ONJ) in patients.
Materials and Methods: A literature review was conducted using the keywords osteonecrosis of the jaws, oral biphosphosnates,
Denosumab, Bevacizumab and Sunitinib. Articles were obtained that reported cases of ONJ associated
with the use of Denosumab, Bevacizumab and Sunitinib.
Results: The literature shows that Denosumab can cause ONJ associated with triggers such as microtraumas or dental
extractions. The combination of the drug along with zoledronic acid may have a synergistic effect. Bevacizumab may
cause ONJ; however, there is much controversy regarding its synergistic action when used with BP. Sunitinib causes
ONJ, and together with BP could increase the risk of developing lesions.
Conclusion: Denosumab, Sunitinib or Bevacizumab are causal agents in the development of ONJ. The combination of
any of these along with BPs could increase the risk of developing ONJ over that posed by BP treatment alone.