Endodontic Treatment Planning in Patients Taking Bisphosphonates

Her anterior teeth have no problems, no decay, molars and premolars are missing on her lower right.

Tooth #12 is already banked (just needs a restoration), tooth #15 asymptomatic and needs a crown.

Tooth #19 is scheduled for RCT and #20 and 21 are likely to have RCTs as well. Note: #20 and 21 test WNL to cold and percussion, #19 lingering response to cold.

Root tips of tooth #3 are partially covered with gingiva and cannot be salvaged. The referring oral surgeon’s treatment plan is NOT to extract any teeth due to a high risk of ONJ. At this time this patient is in a difficult position: on one hand, there is an infection associated with root tips of tooth #3, on the other – the risk for developing osteonecrosis is high.