Table 2.
Oral procedures in patients with current/past or planned BP therapy [28].
| Malignancies | Osteometabolic disorders | ||||
|---|---|---|---|---|---|
| Treatment | Planned BF therapy | Current/past BF therapy | Planned or <3 years of NBP therapy | >3 years of NBP therapy or <3 years with risk factors for BRONJ | |
| Dentoalveolar surgery | Extractive procedures | Recommended | Recommended | Recommended | Recommended |
| Simple extraction1 | Surgical extraction2 | Simple extraction | Surgical extraction2 | ||
| To wait until mucosal healing before starting BF therapy (4–6 weeks) | Recommended therapy suspension from extraction day until mucosal healing (4–6 weeks) | — | — | ||
| Preimplant surgery | Not recommended | Not recommended | Possible | Possible4 | |
|
| |||||
| Implantology | Not recommended | Not recommended | Possible3 | Possible3,4 | |
|
| |||||
| Periodontal surgery | Therapeutic | Recommended2,5 | Recommended2,5 | Recommended | Recommended2 |
| To wait until mucosal healing before starting BF therapy | Recommended therapy suspension | — | — | ||
| (4–6 weeks) | from extraction day until mucosal healing | ||||
| (4–6 weeks) | |||||
| Elective | Not recommended | Not recommended | Possible | Possible | |
|
| |||||
| Endodontic surgery | Recommended2,5 | Recommended2,5 | Recommended | Recommended2 | |
|
| |||||
| Periodontal therapy (scaling/root planning) | Recommended | Recommended | Recommended | Recommended | |
| (every 4 months) | (every 4–6 months) | ||||
|
| |||||
| Conservative | Recommended | Recommended | Recommended | Recommended | |
|
| |||||
| Endodontics | Recommended | Recommended | Recommended | Recommended | |
|
| |||||
| Orthodontics | Possible | Possible (recommended low orthodontic forces) | Possible | Possible | |
|
| |||||
| Fixed prosthesis | Possible | Possible6 | Possible | Possible6 | |
|
| |||||
| Removable prosthesis | Possible | Possible | Possible | Possible | |
| Avoid injuries and pressure sores, to use soft liners eventually | Avoid injuries and pressure sores, to use soft liners eventually | ||||
| (control of the prosthesis every 4 months) | (control of the prosthesis every 4–6 months) | ||||
1If BP therapy cannot be delayed, choose surgical extraction; 2use mucoperiosteal flap for primary closure of the surgical site; 3informed consent for not defined long-term BRONJ risk; 4informed consent for not defined short-term BRONJ risk; 5only for the treatment of significant infectious-inflammatory processes, not otherwise controllable using noninvasive methods; 6respect of the biological width (control of cervical closure-possible supragingival closure).