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Bisphosphonates (BP) are widely used in the therapy of osteoporosis and bone related metastatic lesions. The two main route of administration of these drugs are: per os and intravenous. The administration of BPs may lead to necrosis of the jaws (medication related osteonecrosis of the jaw, MRONJ). Dental implant success is similar in patients receiving oral BPs and patients not taking BPs. Implant failure and MRONJ is more prevalent in patients receiving intravenous BPs than in patients not receiving iv BP therapy. Dental implant placement in patients receiving BPs require risk assessment for every individual case. Success of implantation and development of MRONJ is influenced by the way of BP administration, the medical condition that determines which type of BPs were prescribed, the duration of BP treatment, and comorbidities that increase the risk of MRONJ. The risk of dental implant placement is low in patients receiving oral BPs for less than four years and have no other comorbidities that might increase the risk of MRONJ. In this article the authors are presenting the oral rehabilitation of a patient with endosseal dental implants who have had hereditary spastic paraplegia and long term oral BP therapy for osteoporosis.