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.

 

2 Responses to “Endodontic Treatment Planning in Patients Taking Bisphosphonates”

  1. Pat Stifter says:

    I think this is a marvelous example of reviewing all of the data, including the patient’s medical hx and prognosis, weighing the potential costs vs benefits, and presenting a sound and thoughtful treatment plan for the patient that makes sense for everyone, especially the patient. Thanks for sharing!

  2. Jun ram says:

    Hello Doctor, what material do you recommend to seal the coronal orifice after coronal amputation? What is your comment for amalgam? Thank you

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