title: [Orthodontic treatment of patients medicated with bisphosphonates-a clinical case report].
abstract: BACKGROUND
  Bisphosphonates (BP) are an established medication, e.g., for the prevention/therapy of osteoporosis. The effects of the changed bone metabolism for orthodontic treatments are unknown.
  
  
  METHODS
  A 66-year-old woman underwent a total oral rehabilitation. The therapy included (1) tooth extractions, (2) periodontal treatment, (3) insertion of dental implants, (4) provisional implant restorations, (5) orthodontic treatment, and (6) definite implant restorations. The orthodontic tooth movements were in- and retrusion of the upper frontal teeth, intrusion of the lower front teeth, using the dental implants as skeletal anchorage. After implant insertion and one month before beginning the orthodontic treatment, osteoporosis was diagnosed in this patient and, without notification to our facility, BP treatment was initiated by her general practitioner (alendronate oral, 70 mg/week), with an overall duration of intake of 7 months. After 13 months, the orthodontic treatment was successfully accomplished; however enlarged periodontal gaps, sclerotic bone areas, and mild apical root resorptions of the upper frontal teeth were found in this patient.
  
  
  CONCLUSIONS
  Currently, there are no recommendations for orthodontic patients undergoing BP therapy. Orthodontic tooth movement in this low-risk patient with a short duration of intake and a low-dose BP medication was possible. Because of the reduced bone metabolism and the higher amount of side effects, the treatment should be performed with extremely light forces and frequent monitoring.
authors.affiliation: Department of Orthodontics, Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany. elena.krieger@unimedizin-mainz.de
authors.forename: Elena
authors.initials: E
authors.lastname: Krieger
authors.forename: Bernd
authors.initials: B
authors.lastname: d'Hoedt
authors.forename: Herbert
authors.initials: H
authors.lastname: Scheller
authors.forename: Collin
authors.initials: C
authors.lastname: Jacobs
authors.forename: Christian
authors.initials: C
authors.lastname: Walter
authors.forename: Heinrich
authors.initials: H
authors.lastname: Wehrbein
mesh_terms: D000368:Aged; D019386:Alendronate / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012391:Root Resorption / Q000209:etiology* / Q000517:prevention & control*; D014087:Tooth Movement Techniques / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D015921:Dental Implants; D019386:Alendronate