Bisphosponates and dental implants: a case report and a brief review of literature

This paper reports a brief review of literature about dental implant in patients taking bisphosphonates (BPs) and a case of a patient taking zoledronate, submitted to postextractive implant surgery. A 54-years-old woman was referred to our observation, at the First Section of Dentistry of Department of Medical-Surgical Specialties, University of Catania. The patient, affected by multiple myeloma, reported being subjected to implant surgery, during the administration of zoledronate. Clinical and radiographic evaluations showed an area of BPs-related osteonecrosis in the only postextraction site where no implant was positioned. From this brief review of literature, we can conclude that the risk of bisphosphonates-related osteonecrosis and of implant failure in patients taking oral bisphosphonates may be low. This is a unique case of implant surgery in patient taking intravenous bisphosphonates. For that, we cannot conclude that implant surgery is safe in patients taking intravenous bisphosphonates or that the immediate implant placement following extraction may prevent the osteonecrosis. According to guidelines of AAOMS, to date any kind of surgical procedure involving alveolar bone in patients treated with itravenous BPs is contraindicated. More studies would be needed to optimize the clinical guidelines for the treatment of patients taking BPs.