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An association between bone metabolism and cardiovascular disease was recently reported. A 45-year-old Japanese man was referred to our hospital for the screening of an intraoral infection before surgery for mitral regurgitation. He had been diagnosed with juvenile osteoporosis and had taken the bisphosphonate alendronate sodium hydrate for >9 years. After a consultation with the patient’s primary care physician, we decided to withdraw the alendronate sodium hydrate for 2 months and restart it 1 month before and after the necessary tooth extraction. We performed extraction of the left-side upper and lower molars under local and general anesthesia. The bisphosphonate treatment was withheld before and after the tooth extraction for 3 months. However, at 6 months after the resumption of alendronate sodium hydrate, the hip fracture was caused by falling. In juvenile osteoporosis patients with a mental development delay who are at risk of falling, tooth extraction under continued bisphosphonate treatment is also necessary. Correspondence to: Tsuyoshi Shimo, Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, 1757 IshikariTobetsu, Hokkaido 061-0293 Japan, E-mail: shimotsu@hoku-iryo-u.ac.jp

Tooth extraction in a patient with juvenile osteoporosis and cardiovascular disease