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Intravenous Bisphosphonates for Osteoporosis and Implant Placement
Author(s) -
Reddy Michael S.,
Geisinger Maria L.,
Liu PerngRu,
Holmes Carolyn M.,
Vassilopoulos Philip J.,
Geurs Nicolaas C.
Publication year - 2012
Publication title -
clinical advances in periodontics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.182
H-Index - 2
eISSN - 2163-0097
pISSN - 2573-8046
DOI - 10.1902/cap.2011.110073
Subject(s) - medicine , osteoporosis , zoledronic acid , dentistry , oral hygiene , osteonecrosis of the jaw , implant , bisphosphonate , surgery
Focused Clinical Question In a patient receiving intravenous infusion of nitrogen containing bisphosphonates for management of osteoporosis, is surgical implant treatment contraindicated because of the risk of impaired bony wound healing and osteonecrosis of the jaw? Clinical Scenario A 64‐year‐old postmenopausal woman who leads a busy life and works full time as a business executive presents with a fracture of her maxillary central incisors teeth #8 and #9. She has been a periodontal maintenance patient for the past 20 years with excellent oral hygiene. One month earlier, she experienced trauma to her anterior teeth by walking into a closed patio door. She appears younger than her stated age, and her overall health is good except for a history of postmenopausal osteoporosis diagnosed using a bone mineral density evaluation with a T‐score at lumbar spine of −2.6. Currently, her only medication is a yearly intravenous infusion of zoledronic acid, which she has received for the past 3 years. The reason for this visit is to inform her that the teeth have a hopeless prognosis based on the progressive symptoms and will need to be extracted, and to discuss treatment options, risks, benefits, and alternatives.