The treatment of malignancies often involves the use of targeted therapies to control the growth and survival of malignant cells by interfering with specific molecular agents involved in carcinogenesis [1]. Bevacizumab is a recombinant humanized monoclonal antibody designed to selectively bind and inhibit the biological activity of all human vascular endothelial growth factor (VEGF-A) isoforms. It is mainly used for the treatment of advanced cancers, such as metastatic colon, kidney, brain, and lung cancer [2].

Antiangiogenic agents may increase the risk of medication-related osteonecrosis of the jaw (MRONJ), either as monotherapy or in combination with bisphosphonates [3]. These drugs compromise microvascular integrity and may lead to subclinical jawbone involvement. Moreover, the ability of these drugs to impair angiogenesis explains how bevacizumab can lead to the collapse of the oral mucosa and subsequent bone exposure [4].

Dental implant placement may precipitate MRONJ in patients exposed to bisphosphonates [5,6,7]. Although Greuter et al. in 2008 [8] have reported a case of osteonecrosis of the jaw in a patient receiving bevacizumab therapy after dental extraction, to our knowledge, no similar cases involving dental implants have been previously described. According to the American Association of Oral and Maxillofacial Surgery, dental implant placement should be avoided in oncologic patients receiving antiresorptive therapy or antiangiogenic medications, although antiresorptive therapy for osteoporosis is not an absolute contraindication for this surgical procedure [9]. In another study, dental implants were not recognized as a risk factor for MRONJ in patients receiving denosumab, despite the fact that dental implant placement is inadvisable for cancer patients [10].

Many clinicians are aware of the associated risk of MRONJ around dental implants in patients exposed to bisphosphonates; however, a consensus regarding the use of bevacizumab is still lacking in the literature. Thus, the purpose of this manuscript was to report a rare case of osteonecrosis of the jaw related to the use of bevacizumab in a patient who received dental implants.