Medication-related osteonecrosis of the jaws is associated with antiresorptive drugs such as alendronate, which impair bone healing. This report describes the surgical management of a persistent periapical lesion in a 62-year-old woman with previous alendronate-associated osteonecrosis. The patient, who had used alendronate for over 10 years, underwent lesion curettage, apicoectomy, platelet-rich fibrin application, low-level laser therapy, and antibiotic therapy. Postoperative follow-up showed satisfactory healing, favorable bone repair, and no signs of recurrence or osteonecrosis. Parendodontic surgery can be a safe and effective option in selected patients with a history of bisphosphonate use when minimally invasive techniques and adjuvant therapies are applied.

Graduated in Dentistry from the University of Ribeirão Preto in 2019, specialized in Oral and Maxillofacial Surgery and Traumatology at São Leopoldo Mandic School in 2022, and completed a postgraduate degree in Orofacial Harmonization at Nucci Institute Education in partnership with the Egas Moniz School of Health and Science. Currently, he is pursuing a Master’s degree at São Leopoldo Mandic School and works as an Oral and Maxillofacial Surgeon at Santa Casa de Misericórdia de Descalvado. He has clinical and academic experience in advanced oral surgery, guided bone regeneration, implant dentistry, oral and maxillofacial traumatology, and facial harmonization, as well as participation in international academic activities and scientific research focused on Oral and Maxillofacial Surgery.