Osteonecrosis of the jaw has been identified in recent years as an unfortunate potential side effect for patients taking nitrogen-containing bisphosphonates. Many authors have attempted unsuccessfully to elucidate the mechanism behind this drug-induced malady, leaving dentists with unclear guidelines on how to treat these patients. Recent literature suggests a threshold-related impairment of epithelial cell migration over bone. A conservative, non-invasive approach aimed at preserving the epithelial attachment in a patient on a long-term oral alendronate protocol is described. The advantage of this approach is to prevent a highly destructive bone degenerative process that does not have a clear and predictable treatment protocol.

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