Patient on Bisphosphonates with a Nonrestorable Tooth

Terry Pannkuk, DDS, MScD Instructional, Complications: Advanced Management

What considerations regarding patients on bisphosphonates affect endodontic treatment planning?

Case: Patient with non-restorable teeth on bisphosphonates.

Patient: 80 year old female, multiple myeloma, xerostomia, taking IV Zometa, Dexamethasone

Chief Complaint: biting sensitivity, gross caries, swelling, constant ache

Dental History: Gross caries developed during and after cancer treatment, especially in posterior dental areas

Significant clinical findings: Tooth #31 tested to have a necrotic pulp with severe percussion sensitivity, and localized swelling (palpation sensitivity. Both #31 and #18 have caries extending into the furcation and the teeth cannot be restored to function. Tooth #18 was clearly asymptomatic but #30 might be contributory to her symptoms

Sign In

Subscribe to View the Case

There are 27 images included with this case summary.


Back to All Cases

Join The Discussion

0 comments

Commenting Guidelines Please make scholarly cited references or expert opinions suitable for publication. The comments can either be "pro" or "con" with references to the treatment philosophy. We encourage objectivity and detailed demonstration of knowledge/literature.
You must log in or create a free account to post a comment.

Related Cases

Cavit Piston Technique for Obturating with Bioceramic Sealer Instructional, Obturation, Resorption Management
20 year Recall of a Molar Tooth Having a Crown-Root Fracture Complications: Advanced Management, Fractured Roots, Recall Observations
Hidden Missed Canal Diagnosis, Access, Cleaning and Shaping, Complications: Advanced Management, Missed Canals, Retreatment Strategies
Retreatment of a Perforated 3-Rooted Bicuspid Instructional, Complications: Advanced Management, Missed Canals, Perforations, Retreatment Strategies, Recall Observations
UPDATE RECALL-Retreatment of Surgical Resorption Repair Instructional, Complications: Advanced Management, Resorption Management, Recall Observations