Follow-Up of an Implant-Supported Rehabilitation After Long-Term Use of Alendronate

: Considering the higher number of bisphosphonate prescriptions worldwide and the risk of medicine-related osteonecrosis of the jaws (MRONJs) associated with these drugs, this study aims to report a patient who had weekly used sodium alendronate for 7 years and was submitted to an implant-supported rehabilitation. The alendronate intake was interrupted by the physician 1 year prior to the beginning of the procedures until the whole dental treatment was finished. Moreover, the bone markers procollagen type 1 N-terminal propeptide and C-terminal cross-linking telopeptide of type 1 collagen were also evaluated and showed the following values, respectively: 150 pg/mg and 27.3 μg/L. The rehabilitation consisted of a careful extraction of teeth 34 and 48, external hexagon implants placement at 34, 36, 37, 46, and 47 sites and cone morse at 41 tooth region. During implants insertion, portions of the bone were collected. It was also performed, a gingival graft at 41 region. After 4 months, it was installed the provisional crowns and 1 year later, the definitive ones. It was observed success of the dental rehabilitation, without any clinical or radiographic signs of MRONJ. Moreover, mandibular bone showed normality aspects, with several osteocytes. Although, alendronate use was restarted after the rehabilitation had been finished, the 2-year follow-up has proved the success of the treatment. Based on these findings, it is possible to consider that the clinical protocol ensured the success of the dental rehabilitation, even with the long-term use of a bisphosphonate.