Management of a Malpractice Dental Implant Case in a Patient with History of Oral Bisphosphonates Intake: A Case Report and Narrative Review of Recent Findings

Abstract

The present article aims to describe the management of a malpractice dental implant case in a patient with a history of oral bisphosphonates (BF) intake (alendronic acid every 15 days for 20 years) and to perform a narrative review of recently published articles (2019–2023) on the topic. A female patient rehabilitated with 18 nails in the mandible 20 years ago underwent two surgeries; the first one included the explantation of the nails; the second one included the insertion of two implants in the anterior region. At the last follow-up (21 months from the first surgery and 15 months from the second one) no complications nor episodes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) were highlighted. Furthermore, 12 recent articles on the topic were reported and a narrative review was performed. Based on the narrative analysis, the topic related to dental implants in patients with BF intake seems to remain controversial. Most of the findings highlight how the evidence on both the safety of the treatment and the possibility to foresee the risk of onset based on preoperative factors seem to be scarce. The case described in the present article did not report any complications nor episodes of BRONJ. However, evidence from a single case report is scarce and more clinical trials are required to deepen the knowledge on the topic.

Keywords

• bisphosphonates
• dental implants
• malpractice
• bisphosphonate-related osteonecrosis of the jaw
• BRONJ
• MRONJ