title: Osteonecrosis of the jaw after implant surgery in patients treated with bisphosphonates--a presentation of six consecutive cases.
abstract: BACKGROUND
  Osteonecrosis of the jaws in patients treated with bisphosphonates is mostly associated with intravenous bisphosphonates while the incidence associated with oral bisphosphonates is not significant.
  
  
  OBJECTIVE
  The purpose of this paper is to describe a series of cases of jaw osteonecrosis that may be associated with dental implant placement in patients who had taken nitrogen containing bisphosphonates via oral and/or intravenous route.
  
  
  METHODS
  Six female patients were treated for osteonecrosis of the jaw after implant placement. An average age was 71.8 ± 6.5 years old and they had a history of bisphosphonate use. Two patients suffered from cancer and the other patients had osteoporosis. Two osteoporosis patients had taken only oral bisphosphonate and the other patients received intravenous bisphosphonates.
  
  
  RESULTS
  Resection of necrotized bone, implant removal, and primary closure were performed in five patients and four patients showed uneventful healing. One patient presented recurrence at the maxilla and underwent further extraction and resection. One patient presented with an exposure of the bone after implant placement was treated with an advanced flap closure, and the implants were preserved.
  
  
  CONCLUSIONS
  Unusual jaw necrosis after dental implant surgery might be related with oral and/or intravenous bisphosphonates. Wide resection of necrotic bone, collagen graft, and primary closure are key factors for successful healing.
authors: Private practice, Vallejo, CA, USA.
authors: Yvonne
authors: Y
authors: Tam
authors: Kian
authors: K
authors: Kar
authors: Hessam
authors: H
authors: Nowzari
authors: Hyun-Suk
authors: HS
authors: Cha
authors: Kang-Min
authors: KM
authors: Ahn
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis* / Q000601:surgery; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D015921:Dental Implants; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged
chemical_list: D050071:Bone Density Conservation Agents; D015921:Dental Implants; D004164:Diphosphonates
keywords: bisphosphonate; breast cancer; dental implant; jaw necrosis; multiple myeloma; osteoporosis