Objectives: Atrophic mandibular fractures associated with placement of dental implants is an uncommon condition and to best of our knowledge this event in an oral bisphosphonate user was never described before. Case report: A 74-years-old woman presented a submandibular hematoma and mobility between two fragments on the right side of the body of the mandible after four implants placement. The patient reported the use of oral bisphosphonates for three years for treatment of osteoporosis. A titanium plate was placed at the base of the mandible to fix the fracture and the patient underwent a hyperbaric oxygen therapy for three months. Nine months after the surgery, the patient had no further complications and rehabilitation treatment was completed. Conclusions: The fracture fixation was effective in the treatment of atrophic mandibular fractures in an oral bisphosphonate user, with no occurrence of complications like osteonecrosis. In addition, the oral rehabilitation with prosthesis under the remaining implants showed a satisfactory outcome.