Complexities of Implant Treatment for Patients on Bisphoshonates

[removed][removed] Bisphosonates are a class of oral & IV administered medications used to prevent loss of bone mass in patients suffering from osteoporosis, malignancy-associated hypercalcemia as well as prevention of lytic lesions associated with multiple myeloma and various solid cancers. It is thought to act on bone remodeling by its osteoclast-inhibiting effects. It is however important to note that in a small subset of these patients requiring invasive surgery that jaw osteonecrosis ( exposed bone, pain, infection, swelling, loosening of teeth, purulent discharge) may be observed from months to years after administration of the drug regimen. It appears the incidence is less for patients under an oral regimen versus IV. Risks can be decreased by ensuring all invasive dental procedures to eliminate oral infection and pathology take place prior to introduction of Bisphoshonates and that an increased risk is observed for those on this drug for over 4 years. An in depth review by Grant et al in the JOMS 66.2(2008)
of 115 cases involving implant outcomes in such cases deserves mention.

( Complexities of Implant Treatment for Patients on Bisphoshonates; Diana Bronstein et al, Oral Health, Dec 2016)