title: Dramatic osteonecrosis of the jaw associated with oral bisphosphonates, periodontitis, and dental implant removal.
abstract: BACKGROUND
  Osteoporosis affects millions of elderly patients, and anti-resorptive drugs (ARD) such as bisphosphonates (BP) represent the first-line therapy. Despite the benefits related to the use of these medications, osteonecrosis of the jaw is a significant complication in a subset of patients receiving these drugs.
  
  
  METHODS
  This report documents a case of dramatic bisphosphonate-related osteonecrosis associated with periodontitis and dental implant removal in an osteoporotic patient treated with per os bisphosphonates for an uninterrupted period of 15 years.
  
  
  CONCLUSIONS
  The aim of this report was to discuss the administration period of BP in the treatment of osteoporosis, the decision-making and clinical management of severe MRONJ and the indications for dental implant placement in these specific patients.
authors.affiliation: Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liege, Belgium.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández Ayora
authors.forename: Francine
authors.initials: F
authors.lastname: Herion
authors.forename: Eric
authors.initials: E
authors.lastname: Rompen
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Reginster
authors.forename: Michèle
authors.initials: M
authors.lastname: Magremanne
authors.forename: France
authors.initials: F
authors.lastname: Lambert
mesh_terms: D000284:Administration, Oral; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D003646:Debridement / Q000379:methods; D015921:Dental Implants; D020878:Device Removal; D005260:Female; D006801:Humans; D008336:Mandibular Diseases / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D010166:Palliative Care; D057873:Peri-Implantitis / Q000150:complications* / Q000601:surgery; D010518:Periodontitis / Q000150:complications* / Q000601:surgery; D000068296:Risedronic Acid / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D050071:Bone Density Conservation Agents; D015921:Dental Implants; D000068296:Risedronic Acid
keywords: alendronate; implant; medication related osteonecrosis of the jaw; osteonecrosis; osteoporosis; periodontitis