From: Current state of orthodontic patients under Bisphosphonate therapy
 | Case 1 [[13]] | Case 2 [[13]] | Case 3 [[14]] | Case 4 [[14]] | Case 5 [[14]] | Case 6 [[9]] | Case 7 [[10]] | Case 8 [[11]] | Case 9 [[12]] |
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Anamnesis | Addison´s disease (primary adrenal insufficiency) | Sacral plasmacytoma | Osteoporosis prevention | Osteoporosis prevention | Osteoporosis prevention | Osteoporosis prevention | Osteoporosis prevention | Polyostotic fibrous dysplasia, bilateral cleft lip and palate | Osteoporosis prevention |
Age, gender | 35, female | 77, male | 60, female | 50, female | 74, female | 68, female | 70, female | 15, female | 66, female |
Medication (dose rate) | 1 / week Alendronate 70 mg oral; 1 / day hydrocortisone 30 mg, 1 / day fludrocortisone acetate 0.10 mg, 1 / day calcium with vitamin K + D 1000–1500 mg | 1 / month Zolendronate 500 mg iv; further medication (chemotherapy) | Alendronate oral, dose not specified | Alendronate oral, dose not specified | Alendronate oral, dose not specified; drug holiday 3 months before beginning and during orthodontic treatment | Ibandronate oral, dose not specified | oral, not further specified | 4 cycles of Pamidronate intravenous, 90 or 135 mg every 5 months (45 mg/day, over 2 to 3 days) | 1 / week Alendronate 70 mg oral |
High/low risk patient | medium high risk (due to the corticosteroid medication) | high risk | low risk | low risk | low risk | low risk | low risk | high risk | low risk |
Intake of BP during orthodontic treatment? | yes, 30 months | yes | yes, 24 months | yes | no | yes | yes | no | yes, 6 months |
How long intake before orthodontic treatment and all together? | 41 months before, 58 months all together | 11 months before | 18 months before, 42 months all together | 6 months before, 12 months all together | 36 months before | not specified | 10 years before | 2 years before | 1 month before, 7 months all together |
Intake of BP known by the orthodontists? | yes | yes | yes | no | yes | yes | yes | yes | no, emerged during treatment |
Orthodontic treatment plan | unilateral space closure after extraction of tooth 14 and 44 | space closure after extraction of tooth 42 | closing of right posterior open bite | space closure after extraction of tooth 34 | space closure after extraction of tooth 31 | alignment, distalization 13–15 with skeletal anchorage | orthodontic extrusion of distal root of teeth 36,37 | bone graft for the alveolar cleft to align the upper canines, providing anterior crossbite | intrusion/retrusion of upper and lower frontal teeth using skeletal anchorage |
Duration of orthodontic treatment (months) | 30 | 13 (abortion) | 54 (abortion) | 19 | 14 | 65 for distalization, in total not specified | 7 respectively 5 weeks | 42 | 11 |
Radiographs (end of orthodontic treatment) | radiopaque areas, sclerotic lines, denser bone and widened periodontal ligament on extraction site in the mandible | osteonecrosis in the right mandible (apical 44, 45 and dental implant in region 46) | sclerotic bone areas, widened periodontal gaps | at the extraction site hyper-mineralized areas, sclerotic bone, widened periodontal gaps | mandibular incisors: mild sclerosis and periodontal spaces, mild root resorptions | no abnormality | bone apposition in the apical area | not specified | sclerotic bone areas, widened periodontal gaps, mild apical root resorption of maxillary incisors |
Apical root resorption | none | not specified | none | not specified | yes | not specified | not specified | not specified | yes |
Tooth movement | decelerated | decelerated | decelerated | decelerated | not decelerated | not specified | not specified | not specified | not decelerated |
Complications /noticeable problems | closing and paralyzing of the roots | osteonecrosis with ulceration; no bodily movement, only tipping of the crowns | despite stopping medication, side effects enhanced | compromised parallel roots; mandibular incisor mobility | no increased mobility | no complications reliable to the medication of BP | no clinical evidence of inflammation or pain, and the radiograph | not specified | higher mobility of the frontal lower teeth |