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Table 1 Presentation of the nine reported cases of orthodontically treated patients under BP medication [[9][14]]

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]]

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