[Orthodontic surgical treatment of a patient treated with bisphosphonates : a case]

In last decades, the number of adult patients requesting orthodontic treatments has increased. Orthognathic surgery allows correction of skeletal dysmorphoses in adults. The management of osteoporotic patients treated with bisphosphonates is a major challenge for orthodontists and maxillofacial surgeons. Few studies have been conducted in these patients and four cases of orthognathic surgery have been described to date. A rare case of orthodontic surgical treatment in an osteoporotic patient who has been treated with bisphosphonates is reported. A 38-year-old patient wishing to improve the aesthetics of her face presented in dentofacial orthopedic consultation. Anamnesis revealed a history of bisphosphonate treatment for osteoporosis. The patient presented a hyperdivergent skeletal class III with laterognathia. The occlusal diagnosis was a class III with premolar and canine open bite, interincisal media discordance and dental crowding. The patient was treated by orthodontics and maxillomandibular osteotomy. A postoperative bone Healing delay of four weeks was recorded. This case report discusses the possibility of performing orthodontic treatment associated with orthognathic surgery in patients treated with bisphosphonates in context of osteoporosis. Orthodontics and maxillofacial surgeons must be prepared for the management of patients treated with bisphosphonates. Studies should be considered in order to specify the optimal methods of management.