For people taking certain types of osteoporosis medications,

dental implants can potentially cause a complication known as medication-related osteonecrosis of the jaw (MRONJ). For these patients, dentists often recommend a root canal rather than extraction and replacement with a dental implant to reduce risks. However, a new study suggests that bisphosphonate use may impact the success rate of root canal therapy.

IV Bisphosphonates Lead to Complications

It’s important to note that the bisphosphonates in question here are not the normal tablet variety that many people take for osteoporosis. Instead, it’s the intravenous bisphosphonates that are often prescribed for people following cancer treatment. These IV treatments alter the bone healing pattern more significantly.

Longer Treatment Means Less Success

Researchers looked at the records of 24 patients who received root canal therapy on a total of 37 teeth following treatment with the IV bisphosphonate zoledronate. They found that patients who had received zoledronate for more than a year had significantly lower success rates than those who had received the bisphosphonate for less than a year.

With less than a year of treatment, about 75% of teeth were completely healed, while 17% were only functionally healed and 8% were nonhealing. With more than a year of bisphosphonate treatment, only 4% were fully healed, 84% were functionally healed, and 12% were nonhealing.

Preventive Endodontics

In light of their findings, researchers called for more research with larger studies that could confirm this effect or reaffirm the safety and effectiveness or root canal procedures in people taking IV bisphosphonates. They also said that patients and dentists should consider a “preventive” root canal for patients who might be starting bisphosphonate therapy. Instead of taking a “wait and see” approach to teeth developing risks, it might be better to perform a root canal before bisphosphonate use starts or in the early stages of bisphosphonate therapy when healing is better.

They also note that properly managing these interactions between medications and dental procedures requires an interdisciplinary approach in which doctors and dentists work together.

If you are looking for an Orange County dentist who is prepared to work with your doctor and can help manage complications related to medication, please call  for an appointment at Rice Dentistry in Irvine.