Zolendronic Acid good or Bad for osteoporosis and dental implants

Edited , 4 users are following.

The lower denture of my mother aged 79 years does not fit properly because of gum recession. The maxillofacial surgeon in India recommended her denture implantation. But when I told the doctor that she has taken the 3rd injection of Stoplos One (zoledronic acid) in India on 28.09.2019 and the 1st injection of Olimab (Denosumab) on 01.03.2020, he refused to do the denture implantation as he said it will lead to osteo-necrosis of the jaw or any other serious damage to the bone.

My mother’s recent Bone Mineral Density Test done on 23.02.2020 shows the following:

Site Region T-Score BMD

Left forearm Radius 33% -4.9 0.450g/cm2

Right forearm Radius 33% -3.5 0.573g/cm2

Dual Femur Neck Left -1.7 0.797g/cm2

Dual Femur Neck Right -1.9 0.780g/cm2

AP Spine L1 - L4 -1.4 1.006 g/cm2

The orthopedic doctor has prescribed Olimab S.C. 60 mg injection (Denosumab) found in India . He also prescribed to continue Stoplos One (Zoledronic acid) for 2 more years. My mother has already taken Bonmax Pth (teriparatide) injection for 2 years from October 2015 to September 2017 and Stoplos One (zoledronic acid) for 3 years from October 2017 to October 2019.

I want to know now whether Bisphosphonates like zoledronic acid increases the risk of fractures, irregular heart beat and osteonecrosis of the jaw. Does zoledronic acid suppress bone remodeling which is supposed to stop bone loss. Does low bone density increases the risk of fractures or it is not? A YouTube video on “The end of Osteoporosis” says that Bone Mineral Density is not a good predictor for fractures. Bone density does not equal bone quality. According to the video low bone density does not increase the risk of fractures. Osteoporotic fractures may happen to persons having good bone mineral density.

0 likes, 9 replies

Report / Delete

9 Replies

  • Posted

    Are you sure you understood correctly? I would think that it was because of her osteoporosis not because of the meds she takes for it.

    Report / Delete Reply
  • Posted

    My understanding is that bisphosphonates can lead to fractures if taken for too long. 5 years used to be the cut off point, although some folk now say 3 to 4 years is a safer option.

    They can also be linked to ONJ if invasive treatment is undertaken, but this is fairly uncommon. I went for 2 dental implants while my arms were in plaster and my dentist immediately asked me whether I was on bisphosphonates. As it happened I wasn't, so she was happy to go ahead with them.

    Report / Delete Reply
    • Posted

      Is the same case goes for the Denosumab 60 mg injection also? After bisphosphonates (zoledronic acid) my mother will continue Denosumab 60 mg injection for another 4 years as per Doctoctor's prescription. She already started her first Denosumab injection on 1st March, 2020. Then when will she go for her lower jaw denture implants? Her lower denture is not tightening because of gum recession. So lower denture implant is absolutely must for her to chew food properly according to maxillofacial surgeon in India.

      Report / Delete Reply
  • Posted

    Dentists do not like to do dental work when a patient has taken bisphosphonates or denosumab because of exactly what the dentist said, the possibility of jaw necrosis when the dental surgery 'injures" the bone. That's why when it is known that dental work needs to be done they like to get it out of the way before bisphosphonate therapy.

    Because your mother needed another medication to maintain the improvement provided by teriparatide she was prescribed the zoledronic acid but I don't know why they would add another drug. Are they really giving her the zoledronic acid and the denosumab at the same time (I don't mean like simultaneously on the same day or anything)?

    Has she had a denosumab treatment already?

    Report / Delete Reply
    • Posted

      After 2 years teriparatide course (Bonmax Pth injection) starting from 1st October, 2015 and ending in 1st September 2017, Doctor has prescribed Zoledronic acid 5 mg (Stoplos One)for her. She has taken three injections of zolendronic acid starting from 2nd October, 2017 till 28th September 2019. She thought the course was over . But Orthopedic doctor told us that Zoledronic acid injection can be continued the for another 2 years i.e. 1st October 2020 and 1st October 2021 (max. 5 years). Apart from this injection Doctor has also prescribed Denosumab 60 mg injection (Olimab) for her to be continued for 4 years. She took the first Denosumab injection on 1st March, 2020 and will again take the injection on 1st September, 2020.

      My mother’s recent Bone Mineral Density Test done on 23.02.2020 shows the following:

      Site Region T-Score BMD

      Left forearm Radius 33% -4.9 0.450g/cm2

      Right forearm Radius 33% -3.5 0.573g/cm2

      Dual Femur Neck Left -1.7 0.797g/cm2

      Dual Femur Neck Right -1.9 0.780g/cm2

      AP Spine L1 - L4 -1.4 1.006 g/cm2

      Report / Delete Reply
    • Posted

      She started denosumab injection from 1st March , 2020 and will take the second denosumab injection on 1st September, 2020. She also will take the fourth year zoledronic injection on 1st October, 2020 and the fifth and final one on 1st October, 2021.

      Report / Delete Reply
  • Posted

    My reply which is waiting for moderation is an item which indicates that taking these two medications together increases the risk of jaw necrosis.

    Report / Delete Reply
  • Posted

    Should my mother go forward with two different injections i.e. Zoledronic acid and Denosumab in a month' gap? Or else, skip the two injections to be given in 1st Septembe 2020 (olimab)and 1st October 2020 (Stoplos One) in order to do lower jaw denture implantation by a maxillofacial surgeon.

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up