Preventive Protocol for Tooth Extractions in Patients Treated With Zoledronate: A Case Series

Purpose: We report on an observational longitudinal noncontrolled study of a case series of consecutive patients treated with zoledronate who underwent tooth extractions. The tooth extractions were performed after a preventive protocol to minimize the risk of bisphosphonate-related osteonecrosis of the jaw.Patients and Methods: A total of 43 patients who had received zoledronate and required single or multiple dental extractions were treated. The preventive protocol provided a surgical approach for dental extractions, characterized by the removal of alveolar bone (alveolectomy), and supported by correct antimicrobial therapy (antibiotics and mouthwash).Results: A total of 102 tooth extractions in 43 patients were performed. The follow-up was 12 months. No signs of inflamed tissue or necrotic exposed bone in any patient were observed.Conclusions: With the limits of the present study, we observed that the removal of the alveolar bone after the tooth extractions and correct antimicrobial prophylaxis (antibiotics and mouthwash) could reduce the risk of occurrence of osteonecrosis in patients taking zoledronate.