Osteonecrosis of the alveolar bone has been associated with which therapy?

• A. IV bisphosphonates
• B. Oral calcium supplements
• C. Antibiotics
• D. Vitamin C

Answer: (A)

Osteonecrosis of the jaw is most strongly linked to antiresorptive therapies, especially potent intravenous bisphosphonates used in cancer care. These drugs dramatically slow or halt bone turnover by suppressing osteoclast activity, and they remain in bone for a long time. In the jaw, which normally remodels rapidly after dental trauma or procedures, this suppressed remodeling can impede normal healing. When the jaw is stressed by extractions, infections, or minor injuries, exposed bone may fail to heal and become necrotic, leading to osteonecrosis.

Other options listed do not have a established causal link with this condition. Calcium supplements, antibiotics, and vitamin C play no direct role in triggering osteonecrosis of the alveolar bone. Calcium and vitamin C support general bone and tissue health, while antibiotics target infection rather than causing bone necrosis.