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Thursday, August 25, 2011 susan jenny asks

Q: I've taken Boniva 4 years. Im 64,my bone density increased, am now osteopenic not osteoporotic as before. My question if I stop Boniva when will effects wear off. Concerned as need dental extraction.

The extraction is on a upper molar which had a root canal 8 years ago. It is capped but disintegration of the tooth which was heavily restored is taking place underneath the cap.
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Pam Flores, Health Guide
8/25/11 6:11pm

Hi Susan, welcome! Thanks for your queston.  Can you wait until you have a blood test to check your CTx levels?  This is a test that would tell your oral surgeon if you are at a level that is safe for an extraction after taking Boniva or any bisphosphonate.  I'm going through something similar having taken Actonel years ago and I have periodontitis and jaw bone loss with a bleeding disorder called Von Willebrands.  Normally the oral surgeon will ask you to wait several months after you finish the meds (Boniva) before going forward with the extraction.  The main concern is having an extraction or any invasive dental surgery after taking bisphosphonates since the cavity from the extracted tooth may not heal properly do to impaired blood flow and bone growth.  The issue they worry about is osteonecrosis of the jaw aka BRONJ Bisphosphonate-related osteonecrosis of the jaw.   You want to avoid contracting this!

 

Your oral surgeon should be familiar with the CTx test and the score you need to safely go forward.  Any score above 150 is considered safe to proceed, if it's below that you need to wait a bit longer.  Here's a link from the Osseo News a excellent Dental Web site for Dentists and Oral surgeons.  Read through the threads till you reach what it says about CTx by Dr. Marx or Dr. Ruggiero, two of the leading authorities in osteonecrosis research since 2003.

 

If you have another question don't hesitate to ask.  Good luck with your extraction and notice that they refer to implants and extractions interchangeably since they are both considered invasive procedures which are the type of procedure you have to be careful with.

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By susan jenny— Last Modified: 08/26/11, First Published: 08/25/11