Bisphosphonates — drugs like Fosamax, Boniva, Aclasta, Zometa — are widely prescribed for osteoporosis and bone-related cancer. Long-term use raises a small but real risk of medication-related osteonecrosis of the jaw (MRONJ) after dental surgery, including implants. The risk depends on how long you have taken the drug, the route (oral vs IV), and the specific drug. WeCare's screening protocol determines if implants are safe for you, and adjusts the protocol when needed.
The Risk Categories
Oral bisphosphonates under 4 years use: Risk of MRONJ is low (under 0.1%). Implants generally safe with standard protocol. We may recommend a 3-month drug holiday around surgery if your prescribing physician approves.
Oral bisphosphonates 4+ years use: Risk increases. We perform bone marker blood test (CTX serum) to assess current bone turnover state. CTX above 150 pg/mL → proceed cautiously. Below 150 pg/mL → defer surgery, request 3-6 month drug holiday with prescribing physician.
IV bisphosphonates (Zometa, Aclasta) for osteoporosis: Risk is higher (around 1-2%). Case-by-case evaluation only after thorough discussion of risks and prescribing physician's input.
IV bisphosphonates for cancer (chemo regimens): Risk is significantly higher (5-10%). We typically advise against elective dental implant surgery in active cancer treatment. Conservative dental work (cleanings, fillings) only.
What to Send Us
WhatsApp +90 551 086 83 68 with:
- Recent panoramic X-ray (OPG)
- Full bisphosphonate history (drug name, route, duration, current dose)
- Recent bone density (DEXA) scan if available
- Bone marker (CTX) if you have one
- Prescribing physician's contact
- Other osteoporosis medications
Within 24-48 hours we send a written assessment of whether you are an implant candidate, what protocol modifications would apply, and any pre-surgical preparation needed. As always — your hotel and transfer arrangements are part of the package once we confirm.
