This report documents a case of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after dental
implant placement in an osteoporotic patient treated with alendronate for 6 years. A 63-year-old patient
underwent rehabilitation of the posterior mandible with 2 dental implants in 2006 while taking
alendronate to treat osteoporosis. The surgical procedure was uneventful. Both implants integrated well,
and in November 2006 the patient wore a fixed partial prosthesis. Alendronate was never discontinued.
In June 2008 a painful cheek swelling of the left mandible developed, associated with gingival bleeding.
Since then, the patient underwent several courses of antibiotics, without relief of symptoms. In June
2009 the patient was referred to our department. An area of infected and exposed necrotic bone in the
left mandible enclosed 1 dental implant. A panoramic radiograph and computed tomography scan
showed an increased bone marrow density with peri-implant bone sequestration. The technetium Tc
99m scintigraphy–labeled granulocytes were positive for active bone infection. Bone exposure persisted
for 8 weeks, and diagnosis of oral nitrogen-containing bisphosphonate (N-BP)–related osteonecrosis was
made. On the basis of a review of the literature, this is the 10th case of BRONJ after implant placement
in patients taking oral N-BPs. Despite the low risk of BRONJ occurrence after implant surgery in oral N-BP
users, the fate of dental implants in these patients remains uncertain. Therefore patients at risk must be
given a full explanation of the potential risks of implant failure and BRONJ development. Because the
potential role of infection is still debated, great attention should be paid to the long-term oral hygiene of
implant-prosthetic restorations
Id prodotto:
62262
Handle IRIS:
11562/363466
depositato il:
29 marzo 2012
ultima modifica:
15 novembre 2022
Citazione bibliografica:
Bedogni, Alberto; Bettini, Giordana; Totola, Andrea; Saia, G.; Nocini, Pier Francesco,
Oral bisphosphonate-associated osteonecrosis of the jaw following implant surgery: a case report and literature review.«Journal of Oral and Maxillofacial Surgery»
, vol. 68
, n. 7
, 2010
, pp. 1662-1666