Reprint requests: Prof. Kang-Min Ahn, Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea; e-mail: [email protected]Search for more papers by this author

Yvonne Tam DDS, MS,

Yvonne Tam DDS, MS

Associate doctor

Private practice, Vallejo, CA, USA

Search for more papers by this author

Kian Kar DDS, MS,

Kian Kar DDS, MS

associate professor

Department of Advanced Periodontics, University of Southern California, Los Angeles, CA, USA

Search for more papers by this author

Hessam Nowzari DDS, PhD,

Hessam Nowzari DDS, PhD

principal doctor

Private practice, Beverly Hills, CA, USA

Search for more papers by this author

Hyun-Suk Cha DDS, MSD, PhD,

Hyun-Suk Cha DDS, MSD, PhD

associate professor

Department of Prosthodontics, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea

Search for more papers by this author

Kang-Min Ahn DDS, MSD, PhD,

Corresponding Author

Kang-Min Ahn DDS, MSD, PhD

associate professor

Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea

First published: 27 February 2013

https://doi.org/10.1111/cid.12048

Citations: 33

Share a link

Email
Wechat
Bluesky

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.

Purpose

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.

Patients

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.

Conclusion

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.

References

1 Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003; 61: 1115–1117.
10.1016/S0278-2391(03)00720-1
PubMed Web of Science® Google Scholar
2 Migliorati CA. Bisphosphanates and oral cavity avascular bone necrosis. J Clin Oncol 2003; 21: 4253–4254.
10.1200/JCO.2003.99.132
PubMed Web of Science® Google Scholar
3 Hoff AO, Toth BB, Altundag K, et al. Frequency and risk factors associated with osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. J Bone Miner Res 2008; 23: 826–836.
10.1359/jbmr.080205
CAS PubMed Web of Science® Google Scholar
4 Madrid C, Sanz M. What impact do systemically administrated bisphosphonates have on oral implant therapy? A systematic review. Clin Oral Implants Res 2009; 20(Suppl 4): 87–95.
10.1111/j.1600-0501.2009.01772.x
PubMed Web of Science® Google Scholar
5 Mavrokokki T, Cheng A, Stein B, Goss A. Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 2007; 65: 415–423.
10.1016/j.joms.2006.10.061
PubMed Web of Science® Google Scholar
6 Sedghizadeh PP, Stanley K, Caligiuri M, Hofkes S, Lowry B, Shuler CF. Oral bisphosphonate use and the prevalence of osteonecrosis of the jaw: an institutional inquiry. J Am Dent Assoc 2009; 140: 61–66.
10.14219/jada.archive.2009.0019
PubMed Web of Science® Google Scholar
7 Lazarovici TS, Yahalom R, Taicher S, Elad S, Hardan I, Yarom N. Bisphosphonate-related osteonecrosis of the jaws: a single-center study of 101 patients. J Oral Maxillofac Surg 2009; 67: 850–855.
10.1016/j.joms.2008.11.015
PubMed Web of Science® Google Scholar
8 Marx RE, Sawatari Y, Fortin M, Broumand V. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 2005; 63: 1567–1575.
10.1016/j.joms.2005.07.010
PubMed Web of Science® Google Scholar
9 Bedogni A, Bettini G, Totola A, Saia G, Nocini PF. Oral bisphosphonate-associated osteonecrosis of the jaw after implant surgery: a case report and literature review. J Oral Maxillofac Surg 2010; 68: 1662–1666.
10.1016/j.joms.2010.02.037
PubMed Web of Science® Google Scholar
10 Favia G, Piattelli A, Sportelli P, Capodiferro S, Iezzi G. Osteonecrosis of the posterior mandible after implant insertion: a clinical and histological case report. Clin Implant Dent Relat Res 2011; 13: 58–63.
10.1111/j.1708-8208.2009.00181.x
PubMed Web of Science® Google Scholar
11 Jeffcoat MK. Safety of oral bisphosphonates: controlled studies on alveolar bone. Int J Oral Maxillofac Implants 2006; 21: 349–353.
PubMed Web of Science® Google Scholar
12 Bell BM, Bell RE. Oral bisphosphonates and dental implants: a retrospective study. J Oral Maxillofac Surg 2008; 66: 1022–1024.
10.1016/j.joms.2007.12.040
PubMed Web of Science® Google Scholar
13 Grant BT, Amenedo C, Freeman K, Kraut RA. Outcomes of placing dental implants in patients taking oral bisphosphonates: a review of 115 cases. J Oral Maxillofac Surg 2008; 66: 223–230.
10.1016/j.joms.2007.09.019
PubMed Web of Science® Google Scholar
14 Koka S, Babu NM, Norell A. Survival of dental implants in post-menopausal bisphosphonate users. J Prosthodont 2010; 54: 108–111.
10.1016/j.jpor.2010.04.002
Google Scholar
15 Akintoye SO. Dental implant failure in middle-aged women may be associated with positive history of oral bisphosphonate treatment. J Evid Based Dent Pract 2012; 12: 228–230.
10.1016/j.jebdp.2012.09.012
PubMed Google Scholar
16 Gupta R. Early dental implant failure in patient associated with oral bisphosphonates. Indian J Dent Res 2012; 23: 298.
10.4103/0970-9290.100471
PubMed Google Scholar
17 Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaw – 2009 update. Aust Endod J 2009; 35: 119–130.
10.1111/j.1747-4477.2009.00213.x
PubMed Web of Science® Google Scholar
18 Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws – 2009 update. J Oral Maxillofac Surg 2009; 67: 2–12.
10.1016/j.joms.2009.01.009
PubMed Web of Science® Google Scholar
19 Paquette DW, Brodala N, Williams RC. Risk factors for endosseous dental implant failure. Dent Clin North Am 2006; 50: 361–374.
10.1016/j.cden.2006.05.002
PubMed Google Scholar
20 Rutar A, Lang NP, Buser D, Burgin W, Mombelli A. Retrospective assessment of clinical and microbiological factors affecting periimplant tissue conditions. Clin Oral Implants Res 2001; 12: 189–195.
10.1034/j.1600-0501.2001.012003189.x
CAS PubMed Web of Science® Google Scholar
21 Lazarovici TS, Mesilaty-Gross S, Vered I, et al. Serologic bone markers for predicting development of osteonecrosis of the jaw in patients receiving bisphosphonates. J Oral Maxillofac Surg 2010; 68: 2241–2247.
10.1016/j.joms.2010.05.043
PubMed Web of Science® Google Scholar

Citing Literature

Volume16, Issue5

October 2014

Pages 751-761

Osteonecrosis of the Jaw after Implant Surgery in Patients Treated with Bisphosphonates – A Presentation of Six Consecutive Cases

Abstract

Background

Purpose

Patients

Results

Conclusion

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley