Mandibular bisphosphonate-related osteonecrosis after dental implant rehabilitation:  a case report.
It has been a matter of debate as to whether dental implant therapies are suitable for patients subjected to long-term use of bisphosphonates (BPs). This report presents a case of a 76-year-old woman who developed BPs-related osteonecrosis of the jaw (BRONJ) in the left hemimandible after dental implant exposure. The implants and the necrotic crestal bone were removed, and postoperatively, a delay in tissue healing with bone exposure was noticed. The histologic analysis of the block biopsies revealed a lamellar bone tissue exhibiting necrotic areas and bacterial colonies associated with the bone outer surface. The bone-implant interface showed viable lamellar bone with enlarged vascular spaces in the areas between the implant threads. The possible mechanisms for the loss of implants in BRONJ patients are discussed, and the potential protocols for dental implant rehabilitation for patients under BP therapies are presented.
Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Riberao Preto, University of Sao Paulo, Sao Paulo, Brazil. cesve@forp.usp.br
Cassio Edvard
CE
Sverzut
Alexander Tadeu
AT
Sverzut
Fernando Pando
FP
de Matos
Rogerio Bentes
RB
Kato
Alexandre Elias
AE
Trivellato
Paulo Tambasco
PT
de Oliveira
D000368:Aged; D001706:Biopsy; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology* / Q000601:surgery; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003830:Denture, Partial, Fixed; D020878:Device Removal; D004164:Diphosphonates / Q000009:adverse effects; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects; D008336:Mandibular Diseases / Q000139:chemically induced* / Q000601:surgery; D010010:Osteoclasts / Q000473:pathology; D014945:Wound Healing / Q000502:physiology; D000077211:Zoledronic Acid
D015921:Dental Implants; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid