The importance of a thorough medical and pharmacological history before dental implant placement

Y. Zadik*, J. Abu-Tair, N. Yarom, B. Zaharia, S. Elad

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The risk of osteonecrosis in patients treated with bisphosphonates is well known and guidelines intended to prevent this complication have been established and accepted. Bisphosphonate related osteonecrosis of the jaws (BRONJ) is a unique condition in which even past administration of medication may be of current and future relevance. We present a case of BRONJ in the maxilla after dental implant placement. The patient suffered from osteoporosis and had been treated with oral alendronate sodium in the past. However, the medication was stopped two years before implant placement, and the treating dentist was unaware of the patient's past bisphosphonate use. Prevention of BRONJ is based on identifying at-risk patients, and then avoiding or modifying dentoalveolar surgical procedures in these individuals. Nevertheless, there seems to be some difficulties identifying patients at risk. We present some of the challenges that impede thorough assessment of a patient's medical background (review of systems) in the dental office, and suggest possible solutions.

Original languageEnglish
Pages (from-to)388-392
Number of pages5
JournalAustralian Dental Journal
Issue number3
StatePublished - Sep 2012


  • Alendronate
  • bisphosphonate related osteonecrosis of the jaws
  • education
  • oral medicine
  • oral surgery
  • review of systems


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