A study of peri-implant tissue clinical parameters in patients starting anti-osteoporosis medication after existing implant function: a prospective cohort study

Abstract

Purpose Rare cases of peri-implant medication-related osteonecrosis of the jaw (PI-MRONJ) have recently been reported. Cases that occur after the implant has been functional and the use of anti-osteoporosis medications (AOM) has begun are unpredictable and pose a significant threat to the patient. In this study, we aimed to evaluate the impact of AOM on peri-implant tissues and to examine risk factors for peri-implantitis, which is presumed to be a trigger for PI-MRONJ. Methods The study cohort consisted of patients who underwent implant maintenance treatment between January 2016 and February 2024. Patients were divided into AOM users (AOM group) and controls (control group). Clinical parameters of implant probing depth (iPPD), implant bleeding on probing (iBoP), marginal bone resorption (MBL), and mandibular cortical index (MCI) measured at baseline and at the last visit were statistically evaluated. Risk factors were examined by multivariate analysis for adjusted odds ratios. Results A total of 94 patients (35 male, 59 female) with 270 implants were recruited. The AOM group had 93 implants (24 patients). Comparison of clinical parameters showed that the AOM group had significantly greater changes in iBoP and MBL over time than the control group. Risk factors for peri-implantitis were a history of moderate or severe periodontal disease (OR: 15.8, 95% CI 3.6–69.3) and MCI class 3 (OR: 3.3, 95% CI 1.4–7.8). Conclusions In implant treatment of AOM users in an aging society, special attention should be paid to local inflammation, which is presumed to be the cause of PI-MRONJ.