title: Bone necrosis around dental implants: A patient treated with oral bisphosphonates, drug holiday and no risk according to serum CTX.
abstract: Osteonecrosis of the jaw (ONJ) may appear following certain oral surgery procedures in patients treated with oral bisphosphonates (OB). Guidelines for the treatment of these patients were set out in the American Association of Oral and Maxillofacial Surgeons (AAOMS) Position Paper on Bisphosphonate-Related Osteonecrosis of The Jaws (Position Paper) and Approved by the Board of Trustees in September 2006. For the AAOMS the placement of implants in these patients is not contraindicated. In addition, the serum C-terminal telopeptide bone suppressor marker (CTX) test is available to determine the risk of ONJ. A case is presented of ONJ in a patient with 6 months of OB discontinuation ("drug holiday") before dental implant placement (following the guidelines of the AAOMS) and with no risk of osteonecrosis according to the serum CTX value (340 pg/ml). The wound healed favorably with complete healing at 7 months. In this case, the serum CTX test must be questioned as to its predictive value of ONJ, and more reliable markers of this risk are needed. Key words:Bisphosphonates, dental implants, bone necrosis, serum CTX.
authors.affiliation: Master in Oral Surgery and Implantology. Collaborating Professor of the Master in Oral Surgery and Implantology. Valencia University Medical and Dental School.
authors.forename: A J
authors.initials: AJ
authors.lastname: Flichy-Fernández
authors.affiliation: Master in Oral Surgery and Implantology. Collaborating Professor of the Master in Oral Surgery and Implantology. Valencia University Medical and Dental School.
authors.forename: S
authors.initials: S
authors.lastname: González-Lemonnier
authors.affiliation: Associate Professor of Oral Surgery. Professor of the Master in Oral Surgery and Implantology. Valencia University Medical and Dental School.
authors.forename: J
authors.initials: J
authors.lastname: Balaguer-Martínez
authors.affiliation: Resident of the Master in Oral Surgery and Implantology. Valencia University Medical and Dental School.
authors.forename: Diego
authors.initials: D
authors.lastname: Peñarrocha-Oltra
authors.affiliation: Associate Professor of Oral Surgery. Professor of the Master in Oral Surgery and Implantology. Valencia University Medical and Dental School.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Peñarrocha-Diago
authors.affiliation: Chairman of Stomatology. Valencia University Medical and Dental School. Head of the Service of Stomatology, Valencia University General Hospital.
authors.forename: Jose V
authors.initials: JV
authors.lastname: Bagán-Sebastián