Bisphosphonate-Related Osteonecrosis of the Jaw Following Local Application of Alendronate Gel Around Dental Implants: A Case Report

AbstractAlendronate, which is a second-generation bisphosphonate (BP ) are a class of drugs that s are used to treat osteoporosis. It has been suggested that BP coating on dental implants have a positive effect on new bone formation. The purpose of this study was to assess the risk of bisphosphonate related osteonecrosis of the jaw (BRONJ) even when applied locally.Materials and Methods: 12 systemically healthy patients with 30 edentulous sites aged between 24 years to 56 years desirous of replacing missing teeth with adequate width and height of edentulous area were included in the study. Patients were randomly divided into 2 groups experimental (implant coated with alendronate gel) and control group (implant coated without alendronate gel). Clinical and Radiographical parameters were evaluated at baseline (at the time of implant placement), 3months (at the time of prosthesis placement) and 6 months (3 months after prosthesis placement).Results: Mean PPD showed significant changes at all time intervals and was slightly higher in the experimental group. MCB loss was radiologically lower for the experimental group, but was statistically non-significant when compared to control group. Difference in MBD around dental implants were statistically non- significant at all time intervals in both groups. Out of 30 edentulous sites 1 patients with two tests sites showed the sign of BRONJ.Conclusion: No additional benefits of alendronate was found in our study, also two tests site showed signs of BRONJ despite the local application of alendronate gel.