Impact of a zoledronate coating on early post‐surgical implant stability and marginal bone resorption in the maxilla—A split‐mouth randomized clinical trial

Abstract

Objectives The objective of this clinical study was to evaluate the effect of a bisphosphonate coating on a titanium implant on the implant stability quotient (ISQ) and the radiographic marginal bone levels at implants during early healing (2–8 weeks). Materials and methods In a randomized double‐blind trial with internal controls, 16 patients received a dental implant coated with zoledronate and one uncoated implant as a control. The coated and uncoated implants which were visually indistinguishable were bone level titanium implants with a moderately rough surface and a microthreaded neck. ISQ values were obtained at insertion and at 2, 4, 6, and 8 weeks. Radiographs were obtained at insertion and at 8 weeks. The primary outcome was the difference in ISQ values between the coated implants and the control implants at 4 and 6 weeks, corrected for insertion values. The secondary outcome was loss of marginal bone level from insertion to 8 weeks. Results Implant stability quotient values remained largely constant over the 8 weeks, and there was no significant difference between coated and uncoated implants at any time point. There was 0.12 (SD 0.10) mm marginal bone loss at the control implants and 0.04 (SD 0.08) mm at the coated implants. The difference was 0.17 mm; SD 0.14; p < 0.006). On blind qualitative scoring, 13 of the 15 control implants and two of 15 coated implants showed small marginal bone defects (p = 0.003). Conclusions There were no statistically significant differences observed in ISQ values between the coated and uncoated implants during the early healing. There was less marginal bone loss at the coated implants.

The Effects of Local Alendronate With or Without Recombinant Human Bone Morphogenetic Protein 2 on Dental Implant Stability and Marginal Bone Level: A Randomized Controlled Study

“…The null hypothesis of the present study was accepted for implant stability because all groups showed a similar pattern of stability changes during the period of the study without any statistically significant differences among the groups. This is in line with those found by Abtahi et al, 21 who observed no statistically significant differences in ISQ values between the zoledronate coated and uncoated implants during the early healing (8 weeks). In other studies, Abtahi and colleagues using pamidronate/iban-dronate-coated implants in the maxilla, the coated implants showed a larger improvement in fixation over time as measured by ISQ 22,23 .…”

“…The heterogeneity of the studies investigating the effects of LA of BPs may limit the ability to compare the results of this study and may account for the different results obtained. In the studies of Abtahi et al, [21][22][23] the investigators assessed coated implants against noncoated, while Zuffetti et al, 37,38 evaluated local application of BPs solution. Moreover, the periods of follow-up differed with their time points, the doses of medications and the methods of application also differed as well as implant placement whether submerged or none and jaw sites.…”

Impact of bisphosphonate drugs on dental implant healing and peri-implant hard and soft tissues: a systematic review

“…In Abtahi et al [ 26 ] study, zoledronate coated vs uncoated dental implants were compared. These two types of implants were indistinguishable by a blinded operator.…”

“…According to Abtahi et al [ 26 ] there are no statistical differences between the use of bisphosphonate coated dental implant or uncoated ones during the early healing phase. Uncoated dental implants just presented more marginal bone loss than test group.…”

The role of bisphosphonates in success and survival of dental implants - effects in osseointegration

“…Another study from Jahan Abtahi et al 23 was a splitmouth randomized clinical trial and showed that there is no lack of stability (fixation) in coated implants (solution with 2 mg/ml zoledronic acid) and there is no marginal resorption, in contrast with the non-coated implants.…”