Dental implants in a patient with Paget’s disease: a case report


  • Marcus Azevedo Amaral University of São Paulo
  • Aline Semblano Carreira Falcão Federal University of Pará
  • Mayara Sabrina Luz Miranda Federal University of Pará
  • Valtuir Barbosa Félix Federal University of Pará
  • Sérgio de Melo Alves Jr Federal University of Pará
  • Maria Sueli da Silva Kataoka Federal University of Pará



Paget’s disease, dental implants, bisphosphonates.


Objective: Paget’s disease (PD) is a metabolic bone disease characterized by increased bone resorption followed by excessive, unregulated bone formation. While its etiology remains elusive, several genetic and environmental factors have been implicated. PD results in weakened bone strength and abnormal bone architecture, which may be unfavorable for the placement of osseointegrated dental implants. Herein, we describe a patient with PD who received dental implants.
Case description: An 86-year-old woman diagnosed with PD and treated with oral bisphosphonates, was referred for implant treatment. Four dental implants were fixed in the anterior mandible, and all implants presented good primary stability. The patient was followed for a period of 6 years. No clinical mobility or signs of looseness were observed, and the implants were successfully osseointegrated.
Conclusion: We conclude that the use of bisphosphonates in PD can be an important role in the insertion and osseointegration of dental implants. However, additional research is needed to confirm these findings.


Whyte MP. Clinical Practice. Paget’s disease of bone. N Engl J Med 2006; 355:593-600.

Michou L, Brown JP. Emerging strategies and therapies for treatment of Paget’s disease of bone. Drug Des Devel Ther 2011;5:225-39.

Bi Y, Gao Y, Ehirchiou D, Cao C, Kikuiri T, Le A, et al. Bisphosphonates cause csteonecrosis of the jaw-like disease in mice. Am J Pathol 2010; 177(1):280-90.

Alsaadi G, Quirynen M, Michiles K, Teughels W, Komárek A, van Steenberghe D. Impact of local and systemic factors on the incidence of failures up to abutment connection with modified surface oral implants. J ClinPeriodontol 2008; 35(1):51-7.

Erdogan O, Shafer DM, Taxel P, Freilich MA. A review of the association between osteoporosis and alveolar ridge augmentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104(6):738 e1-13.

Hwang D, Wang HL. Medical contraindications to implant therapy: part I: absolute contraindications. Implant Dent 2006; 15:353-60.

Hwang D, Wang HL. Medical contraindications to implant therapy: part II: relative contraindications. Implant Dent 2007; 16:13-23.

Chung PY, Van Hul W. Paget’s disease of bone: evidence for complex pathogenetic interactions. Semin Arthritis Rheum 2011; 41(5):619-41.

Otomo-Corgel J. Implants and oral bisphosphonates: risky business? J Periodontol 2007; 78(3):373-6.

Sarasquete M, González M, San Miguel JF, García-Sanz R. Bisphosphonate-related osteonecrosis: genetic and acquired risk factors. Oral Diseases 2009; 15(6):382-7.

Filleul O, Crompot E, Saussez S. Bisphosphonate-induced osteonecrosis of the jaw: a review of 2,400 patient cases. J Cancer Res Clin Oncol 2010; 136(8):1117-24.

Hellstein JW, Adler RA, Edwards B, Jacobsen PL, Kalmar JR, Koka S, et al. Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: Executive summary of recommendations from the American Dental Association Council on Scientific Affairs. JADA 2011; 142:1243-51.

Flichy-Fernández A-J, Balaguer-Martínez J, Peñarrocha-Diago M, Bagán JV. Bisphosphonates and dental implants: Current problems. Med Oral Patol Oral Cir Bucal 2009; 14(7):E355-60.

Rasmussen JM, Hopfensperger ML. Placement and restoration of dental implants in a patient with Paget’s Disease in remission: literature review and clinical report. Journal of Prosthodontics 2007; 17:35-40.

Torres J, Tamimi F, Garcia I, Herrero A, Rivera B, Sobrino JA, et al. Dental implants in a patient with Paget disease under bisphosphonate treatment: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107(3):387-92.






Case Report