The incidence of ONJ disease seems relatively low in patients receiving oral bisphosphates for osteoporosis or Paget's disease and considerably higher in patients with malignancy receiving high doses of intravenous bisphosphates.(7,8) Despite an excellent safety profile for parathyroid hormone (PTH), concerns do arise from its persistence after discontinuation without sequential use of antiresorptive drugs.(9,10) In addition, PTH is not recommended for patients with a risk of osteosarcoma. Here, PTH is linked to Paget disease.