Preserving periodontally compromised abutments in patients who are actively undergoing oral and intravenous bisphosphonate treatment for osteoporosis provides an alternative to tooth extraction and dental implants, both of which put patients at risk for bisphosphonate-related osteonecrosis of the jaw. This case report describes how a CAD/CAM-fabricated cobalt-chromium telescopic prosthesis was placed on periodontally compromised abutments of a 74-year-old woman actively undergoing oral and intravenous bisphosphonate treatment for osteoporosis.