Failure Risk Estimates After Dental Implants Placement Associated With Plasma Rich in Growth Factor-Endoret in Osteoporotic Women Under Bisphosphonate Therapy

Abstract

There is disagreement as to whether it is safe to place implants in patients under bisphosphonates (BPs) therapy owing to the risk for developing BP-related osteonecrosis of the jaws (BRONJ). The American Association of Oral and Maxillofacial Surgeons recommends that dental implants should be avoided in oncologic patients treated with intravenous BPs. Conversely, for patients receiving oral BPs, dental implant placement is not explicitly contraindicated even if a cautious approach is suggested. The aim of the current study was to assess the risk level as related to adverse events such as implant failure and BRONJ in a large cohort of osteoporotic patients submitted to implant placement and concomitant application of plasma rich in growth factor (PGRF)-Endoret. The clinical charts of 235 middle-aged women under oral BPs therapy for osteoporosis, who underwent positioning of 1267 dental implants, were reviewed. The implants were always positioned in association with PRGF-Endoret. The outcomes were implant failure and BRONJ. A model based on personal risk factors distribution was used for risk assessment. Sixteen implants were lost in 16 patients up to 120 months of follow-up, leading to a survival of 98.7% and 93.2% on an implant basis and patient basis, respectively. No cases of BRONJ were reported. In line with the current literature, the present data show that the risk for developing BRONJ associated to dental implant surgery remains low for patients receiving oral BPs. The use of procedures that could enhance and support healing, such as platelet concentrates, should be recommended.

General Diseases Influence on Peri-Implantitis Development: a Systematic Review

“…Three other studies [15-17] did not find any significant differences for implantation success neither for osseointegration quality between osteoporotic and control groups. Holahan et al [16] found that osteoporosis did not show any correlation to local jaw bone quality, but when it was, set subjectively by surgeon, it highly correlated with implantation success (P < 0.01).…”

“…In total 16 prospective studies [14,18,19,28,35-40,44,45,47,48,50,53] from which 5 were controlled clinical trials [38-40,44,48] and 1 cross-sectional study [45], 23 retrospective studies [15-17,20,23-27,29-34,41-43,46,49,51,52,54] and two case series studies [21,22] were included in present research.…”

“…Holahan et al [16] found that osteoporosis did not show any correlation to local jaw bone quality, but when it was, set subjectively by surgeon, it highly correlated with implantation success (P < 0.01). It should be noted that Mozzati et al [15] combined many different implantation methods, such as immediate function loading, immediate implantation and sinus lifting. Sinus lift was mentioned as relevant implant failure risk factor.…”

“…Sinus lift was mentioned as relevant implant failure risk factor. Also, patients with various risk factors, including diabetes mellitus, smoking, corticosteroid users, oral BP users, were combined in this study [15]. …”

Farkli Dental İmplantlarin Başari Oranlarinin Geri̇ye Dönük Olarak Değerlendi̇ri̇lmesi̇

“…23,24 Literatüre göre, oral bifosfonat kullanan hastalarda dental implant cerrahisi ile ilişkili bifosfanat kullanımına bağlı çenelerin osteonekrozu (BRONJ) gelişme riski düşüktür. 16,25,26 Diz ve ark. tarafından yapılan bir derlemede, dental implant uygulamasını takiben BRONJ gelişen hastaların 11'inin oral 16' sının ise intravenöz olarak bifosfanat kullanmakta olduğu, ayrıca implant uygulaması ve BRONJ gelişimi arasında ortalama 16 ay olduğu belirtilmiştir.…”