Effect of Dental Implants on Bisphosphonate-Related Osteonecrosis of the Jaws

Holzinger, Daniel; Seemann, Rudolf; Matoni, Nadja; Ewers, Rolf; Millesi, W.; Wutzl, Arno

doi:10.1016/j.joms.2014.04.037

Cited by 71 publications

(69 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent reports suggest that implants inserted before patients with cancer or osteoporosis are treated with BPs are unlikely associated with subsequent occurrence of BRONJ if oral health is appropriately managed [25,26]. However, dental implantation performed during or after BP treatment is a potential risk factor for BRONJ.…”

Section: ) Dental Implants and Aronjmentioning

confidence: 99%

Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw

et al. 2016

View full text Add to dashboard Cite

Section: ) Dental Implants and Aronjmentioning

confidence: 99%

Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw

et al. 2016

View full text Add to dashboard Cite

“…The literature dealing with this topic can roughly be separated into three groups:BP-ONJ case series exclusively triggered by implants in patients with malignant and benign diseases [9, 10, 16–19],BP-ONJ case series analyzing case series of BP-ONJ of which varying amounts are caused by implants in part among patients with malignant and benign diseases [20–23] andimplant studies performed exclusively in patients with benign diseases, mostly osteoporosis [24–31]. In very few of these studies, the primary disease was not given, but the prescribed bisphosphonates strongly suggest osteoporosis as the primary disease (see Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, there are studies describing the safety of dental implant surgery in patients with oral BP and osteoporosis with no occurring BP-ONJ cases [5]. However, there are cases of successful implant insertion in patients with malignant primary diseases and cases of BP-ONJ in patients with osteoporosis [9, 10]. Reviews mention that there are only very few retrospective studies with moderate strength of evidence addressing this topic [11] so that no final recommendation can be given [12].…”

Section: Introductionmentioning

confidence: 99%

Dental implants in patients treated with antiresorptive medication – a systematic literature review

et al. 2016

View full text Add to dashboard Cite

ObjectiveBisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.MethodsThe PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.ResultsThere is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.ConclusionSuccessful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.

show abstract

“…Moreover, ''Blue rose'' cases, in which dental implants were inserted after administering intravenous BP, were precisely investigated in some studies [16,18]. Holzinger et al [23] reported that the insertion of dental implants during or after BP treatment accelerated the development of BRONJ, but this occurred less frequently when the implant had been inserted before BP therapy had been started. Therefore, it is important to clarify the status and the natural history of BRONJ at the implant site in patients administered with intravenous BP.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of dental implants as a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw in breast cancer patients

et al. 2015

View full text Add to dashboard Cite

It remains unclear whether dental implants are a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). We retrospectively evaluated the status of dental implants in patients given intravenous bisphosphonates (BPs) in a breast cancer cohort to elucidate the risk for BRONJ at the implant site. We established a BRONJ oral monitoring program for 247 breast cancer patients given intravenous BP in our institution. The 3-year cumulative incidence rate was determined. The systemic and local risk factors of 44 patients who completed comprehensive oral examinations were evaluated by logistic regression analysis. The 3-year cumulative incidence rate of the 247 patients was 0.074 % (8/247, 95 % CI 0.0081-0.014). In the 44 orally examined patients, 6 (13.6 %: 6/44) had dental implants. Of these 6 patients, 1 developed BRONJ at the implant site. There were no significant differences in the age, total BP treatment period, number of residual teeth, time of regular oral monitoring, oral hygiene level, or dental implant insertion. Although a case of ONJ was identified, dental implants which were inserted before intravenous BP administration were not a risk factor for the development of ONJ in breast cancer patients.

show abstract

Effect of Dental Implants on Bisphosphonate-Related Osteonecrosis of the Jaws

Cited by 71 publications

References 33 publications

Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw

Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Evaluation of dental implants as a risk factor for the development of bisphosphonate-related osteonecrosis of the jaw in breast cancer patients

Contact Info

Product

Resources

About