Is it necessary to stop bisphosphonate (Bisphosphonate) therapy before oral surgery to prevent bisphosphonate-related osteonecrosis of the jaw (BRONJ)?

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Last updated: December 30, 2025View editorial policy

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Evidence for Stopping Bisphosphonates Before Oral Surgery

There is insufficient evidence to support routine discontinuation of bisphosphonates before oral surgery, and the decision to stop therapy must balance the minimal protective benefit against the risk of skeletal complications. 1

The Evidence Against Drug Holidays

The most recent ASCO/MASCC/ISOO guideline (2019) explicitly states there is insufficient evidence to support or refute the need for discontinuation of bisphosphonates before dentoalveolar surgery, with only a weak strength of recommendation. 1 This represents the highest quality guideline evidence available.

The biological rationale for drug holidays is questionable because:

  • Bisphosphonates remain in bone for years after discontinuation, making short-term interruptions unlikely to provide meaningful protection 2
  • Some experts hypothesize a 2-month discontinuation may improve bone healing, but this remains unproven 2, 3
  • The alternative view holds that brief interruptions have no effect given the prolonged skeletal retention of these drugs 2

Risk Stratification Is Critical

The risk of medication-related osteonecrosis of the jaw (MRONJ) varies dramatically by indication and route:

Oral bisphosphonates for osteoporosis:

  • Incidence is very rare at <1 case per 100,000 person-years 1, 2
  • Risk remains extremely low even with dental procedures 1

Intravenous bisphosphonates for cancer:

  • Incidence ranges from 6.7-11% in multiple myeloma patients receiving monthly high-dose therapy 1, 2
  • Risk increases substantially with duration beyond 2 years 1

Evidence-Based Prevention Protocol

The strongest recommendation is to complete all necessary dental work before initiating bisphosphonate therapy, which eliminates MRONJ risk entirely. 1, 2, 4

Before starting bisphosphonates:

  • Perform comprehensive dental evaluation including radiographic examination 1, 4
  • Complete all invasive dental procedures 1, 2
  • Treat all active oral infections 3
  • Correct vitamin D deficiency to prevent hypocalcemia 2, 5, 6

Management When Surgery Is Needed During Therapy

For patients on oral bisphosphonates for osteoporosis, the FDA labels for both alendronate and risedronate state that discontinuation of bisphosphonate treatment may reduce the risk for ONJ, with clinical judgment guiding management based on individual benefit/risk assessment. 5, 6

If dental surgery must proceed:

  • Use perioperative prophylactic antibiotics 2, 3, 7
  • Employ atraumatic extraction technique with primary closure 7
  • Smooth bone edges and prepare tension-free mucoperiosteal flaps 7
  • Leave sutures in place for 14 days minimum 7
  • Schedule follow-up every 6-8 weeks until complete mucosal healing 1, 3, 4
  • Defer resumption of bisphosphonates until healing is confirmed 3, 4

Critical Caveats for Cancer Patients

For patients receiving intravenous bisphosphonates at oncologic doses, interrupting therapy poses tangible risks:

  • Pathologic fractures may occur during drug holidays 2
  • Spinal cord compression risk increases 2
  • At least 60% of MRONJ cases occur after dentoalveolar surgery, making prevention paramount 2, 8

The decision to interrupt IV bisphosphonates requires consultation with the oncologist to weigh skeletal event risk against MRONJ risk. 2, 4

Common Pitfalls to Avoid

  • Do not confuse osteoporosis risk (<1/100,000) with cancer treatment risk (6.7-11%) when counseling patients 1, 2
  • Do not perform extractions without antibiotic prophylaxis, as infection is a key MRONJ trigger 2, 3, 7
  • Do not assume drug holidays are protective given the lack of evidence and prolonged skeletal retention 1, 2
  • Do not proceed with elective procedures (implants, non-medically necessary extractions) during active high-dose bisphosphonate therapy 1

Ongoing Monitoring Requirements

Patients on bisphosphonates require:

  • Dental check-ups every 6 months once therapy has commenced 1, 4
  • Maintenance of excellent oral hygiene 1, 4
  • Adequate calcium (800-1000 mg/day) and vitamin D (800 IU/day) supplementation 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Bisphosphonate Discontinuation and Osteonecrosis of the Jaw Risk

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Tooth Extraction in Patients Receiving Zoledronic Acid

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Bisphosphonate Therapy in Dental Procedures

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Principles of oral surgery for prevention of bisphosphonate-related osteonecrosis of the jaw.

Oral surgery, oral medicine, oral pathology and oral radiology, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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