Dramatic osteonecrosis of the jaw associated with oral bisphosphonates, periodontitis, and dental implant removal

Abstract

Introduction Osteoporosis affects millions of elderly patients, and anti-resorptive drugs (ARD) such as bisphosphonates (BP) represent the first-line therapy. Despite the benefits related to the use of these medications, osteonecrosis of the jaw is a significant complication in a subset of patients receiving these drugs. Case presentation This report documents a case of dramatic bisphosphonate-related osteonecrosis associated with periodontitis and dental implant removal in an osteoporotic patient treated with per os bisphosphonates for an uninterrupted period of 15 years. Conclusion The aim of this report was to discuss the administration period of BP in the treatment of osteoporosis, the decision-making and clinical management of severe MRONJ and the indications for dental implant placement in these specific patients.