Bisphosphonates and dental implant treatment, what do I need to know?

Bisphosphonates are drugs which have the function of inhibiting bone resorption. Certain bone cells called osteoclasts are inhibited of resorbing bone.

This family of drugs are used to treat various diseases such as osteoporosis, multiple myeloma and bone metastases associated with breast cancer or prostate cancer.

The administration of bisphosphonates seems to be related with osteonecrosis of the jaw so it is important to know how to act if you need surgery or dental implants and extractions when you are taking bisphosphonates. Patients undergoing oral surgery while taking bisphosphonates can experience osteonecrosis.


What Osteonecrosis means?

Osteonecrosis is a form of chronic osteomyelitis (which is infection and inflammation of the bone or bone marrow). This develops slowly and is characterized by the appearance of exposed bone in the mandible or maxilla with evolution time up to 6 weeks in patients who have received or are receiving treatment with this medicine.

It could be diagnosed by your dentist and should be based on clinical, radiological imaging and histopathology. It is presented as an exhibition of alveolar bone sometimes after a tooth extraction and dental implant surgical procedures

Administration routes & risks

It is unclear the risk / benefit ratio in the placement of dental implants, but depending on the route of administration there are two guidelines to follow.


If the patient is taking bisphosphonates intravenously , the dental implant placement is totally contraindicated.

When the administration route is orally the patient can have the chance of implant treatment taking into account guidelines for action to avoid the risk of osteonecrosis.

It is recommended the placement of the dental implants before the patient starts taking bisphosphonates and letting time pass for osseointegration. Also patient must to be informed about the importance of establishing healthy habits as good oral hygiene or stop smoking.

Assessing risks

It is important and necessary to know how long patients have been taking oral bisphosphonates. When the patient has taken oral bisphosphonates for less than 3 years then there is lower risk of any problems occurring after oral surgery. In these instances special measures should be taken to prevent infection after surgery. Dental Implants can be placed carefully with sufficient irrigation and low speed to minimise bone trauma during surgery.

If patients have taken oral bisphosphonates for more than 3 years then special measures should be taken to minimise the risk of osteonecrosis. Under authorisation of the specialist who prescribed bisphosphonates advice should be sought as to the risk of undergoing oral surgery.

For more information about dental implants, please feel free to Contact Brighton Implant Clinic or Call us on 0800 111 6623.

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