Non-exposed bisphosphonate-related osteonecrosis of the jaws is a newly reported complication arising from bisphosphonate therapy characterized by atypical symptoms and no apparent mucosal fenestration or exposure of necrotic bone. We present a case that could not be classified into any proposed stage because it had findings associated with stages 0 and 3. Woman, 66, had a history of intravenous bisphosphonate therapy over the past 6 months and implant surgery 2 months previously. She developed non-exposed osteonecrosis of the mandible. Clinical examination revealed an intact oral mucosa around the implants with signs of fistulae or bone exposure. Computed tomography scans showed pathologic fracture of the mandible involving one of the implants. Treatment consisted of bone resection and fixation with the mandibular reconstruction plate with platelet-rich plasma. The patient’s bone/mucosal healing allowed her to resume wearing the implant-supported prostheses 4 months after surgery.