Osteogenesis imperfect (OI) is a group of genetically diverse connective tissue disorders.
Bisphosphonates therapy to manage bone fragility, a now common medical
therapy for OI, can increase the risk of
bisphosphonate-associated osteonecrosis of the jaws. In this report, a 6 ½ year child, who was receiving
bisphosphonate therapy for OI, underwent full mouth dental rehabilitation in the operating room while under
general anesthesia. The child had numerous teeth restored and multiple primary molar extractions. The patient, who received prophylactic
antibiotics intraoperatively, demonstrated no clinical signs of
bisphosphonate-associated osteonecrosis when seen at follow-up. Although
bisphosphonate osteonecrosis is a possible sequel in children who receive multiple extractions, no clinical signs were manifested in our patient, who required multiple primary tooth extractions along with restorative treatment under
general anesthesia. While no dental guidelines have been developed to manage OI children having been treated with
bisphosphonates, consent for extractions should include the risk of
bone necrosis and careful post-operative observation to monitor wound healing.