The present study aimed to identify and report the association of bisphosphonate-related osteonecrosis of the jaw (BRONJ) with advanced peri-implantitis and implant removal, and further promote the awareness of this newly emerging complication. Four female patients presented with discomfort and pain on the dental implants placed 5–16 years ago. They were prescribed oral bisphosphonate after 3–14 years of post-implant osseointegration. Owing to advanced peri-implantitis, all the patients underwent implant removal, following which, they developed BRONJ. Initially, in a clinical setting of private practice, antibiotic medications were prescribed, and surgical debridement was performed. However, only one patient could be successfully treated. The symptoms persisted and worsened in the other three patients. They were subsequently referred to University hospitals for further treatment. Many dentists assess the risk of BRONJ before implant placement. However, an increasing number of patients initiate bisphosphonate medication for osteoporosis and other reasons because of increased life expectancy and availability of medical care; these factors may pose a significant impact on patients with advanced peri-implantitis. Therefore, in light of these findings, dentists should be aware of the possibility of BRONJ in such cases.

This content is only available as a PDF.
You do not currently have access to this content.