Development of Antiresorptive Agent-Related Osteonecrosis of the Jaw After Dental Implant Removal: A Case Report

• Published in: The Journal of oral implantology Vol. 44; no. 5; pp. 359 - 364
• Main Authors: Yamamoto, Shinsuke, Maeda, Keigo, Kouchi, Izumi, Hirai, Yuzo, Taniike, Naoki, Yamashita, Daisuke, Imai, Yukihiro, Takenobu, Toshihiko
• Format: Journal Article
• Language: English
• Published: United States Allen Press Inc 01.10.2018
• Subjects: Anesthesia; Bisphosphonates; Bone diseases; Bone implants; Bone marrow; Case reports; Dental implants; Dental prosthetics; Dental restorative materials; Dentistry; Dentures; Family medical history; Hospitals; Jaw; Mandible; Metastasis; Multiple myeloma; NMR; Nuclear magnetic resonance; Osteonecrosis; Osteoporosis; Patients; Transplants & implants; bisphosphonate; antiresorptive agent-related osteonecrosis of the jaw; dental implant removal; osteoporosis
• ISSN: 0160-6972; 1548-1336
• DOI: 10.1563/aaid-joi-d-18-00032

Dental implant treatment is a highly predictable therapy, but when potentially lethal symptoms or complications occur, dentists must remove the implant fixture. Recently, reports on antiresorptive agent-related osteonecrosis of the jaw have increased in the field of dental implants, although the relationship between dental implant treatment and antiresorptive agents remains unclear. Here, we report a case of antiresorptive agent-related osteonecrosis of the jaw that developed after dental implant removal. A 67-year-old Japanese woman with a medical history of osteoporosis and 7 years of oral bisphosphonate treatment was referred to our hospital with a chief complaint of painful right mandibular bone exposure. A family dentist removed the dental implants from the right mandible using a trephine drill without flap elevation in August 2016. However, the healing was impaired; she was referred to our hospital 3 months after the procedure. We performed a sequestrectomy of the mandible under general anesthesia. In conclusion, this patient's course has two important implications: First, the removal of dental implants from patients who are prescribed oral bisphosphonates for long durations can cause antiresorptive agent-related osteonecrosis of the jaw. Second, meticulous procedures are required to prevent and treat the development of antiresorptive agent-related osteonecrosis of the jaw after dental implant removal.