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Bisphosphonates effectively increase bone mineral density and reduce fracture risk in patients with osteoporosis, but there are concerns about osteonecrosis of the jaw (ONJ) and atypical femoral fractures (AFFs) in the long-term users. So far both complications have not been reported as occurring simultaneously in an osteoporotic individual on oral alendronate.

Atypical Femoral Fractures Shortly After Osteonecrosis of the Jaw in a Postmenopausal Woman Taking Alendronate for Osteoporosis