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Background  Bisphosphonate use in adult patients has been linked to osteonecrosis of the jaw (ONJ). This complication has not been systematically assessed in a paediatric population receiving bisphosphonates.

Objective  To assess our cohort of paediatric patients treated with intravenous bisphosphonate for occurrence of ONJ.

Design  Observational study at a tertiary children's hospital.

Patients  A total of 42 paediatric patients with osteoporosis who received bisphosphonate infusions for a mean of 6·5 years (SD 2·7 years) were assessed clinically and radiographically for possible ONJ. Among 42, 37 patients had received disodium pamidronate 1 mg/kg/dose at a mean cumulative dose of 19·8 mg/kg and zoledronic acid (ZA) 0·05 mg/kg/dose at a mean cumulative dose of 0·49 mg/kg; four had received ZA and one received pamidronate alone. Invasive dental treatment during bisphosphonate treatment, a …