Osteoporosis literally means porous bone. There is a reduction of density and quality of bone with this disease. As bones become more porous and fragile, the risk of fracture is greatly increased. The loss of bone occurs silently and progressively. Often there are no symptoms until the first fracture occurs. This condition is commonly seen in post menopausal women.


One of the common treatments for osteoporosis is administration of a group of medications known as bisphosphonates which slow bone loss and reduce risk of fracture. One of the side effects of these drugs is spontaneous bone death (osteonecrosis), including upper and lower jawbones. This risk is greatly increased when the upper or lower jawbone is exposed during a dental surgical procedure (extraction, implant placement, periodontal surgery, etc). Accordingly, it is very important to get any needed periodontal treatment completed BEFORE starting on bisphosphonate therapy. Also, while on bisphosphonate therapy, it is important to stay on a strict periodontal maintenance program to prevent the need for invasive surgical dental treatment, which could put the patient at significant risk for osteonecrosis.

There are three levels of administration for these medications…oral, IM, IV/infusion. There is an incremental increase in risk for osteonecrosis as the patient goes from oral to IV infusion.

Commonly Prescribed Osteoporosis Medications (Bisphosphonates)

  • Risedronate(Actonel)
  • Alendronate(Fosamax)
  • Ibandronate (Boniva)
  • Zoledronic Acid (Reclast)
  • Pamidronate (Aredia)
  • Etidronate (Didronel)


Examples of Bisphosphonate osteonecrosis after single tooth extraction and implant placement

P3 Dental offers locally applied pharmaceutical formulations to reduce the chances of developing jawbone osteonecrosis associated with bisphosphonate therapy.


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