Osseointegration of dental implants and osteonecrosis of the jaw in patients treated with bisphosphonate therapy: A systematic review

Abstract

Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone pathoses. The aim of this study was to conduct a systematic review in order to evaluate whether patients on BP therapy are appropriate candidates for dental implants as compared to patients not taking BP with respect to successful implant osseointegration and the risk of developing bisphosphonate-related osteonecrosis of the jaw (BRONJ). Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations and hence results must be interpreted in this context. Well-controlled studies with higher strength of evidence and larger population sizes are required to more accurately address this topic in the future.

All‐on‐4® Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7‐Year Clinical and 5‐Year Radiographic Retrospective Case Series with Risk Assessment for Implant Failure and Marginal Bone Level

“…40,41 On the other hand, no specific effect of bisphosphonate medication on implant success has been reported by systematic reviews 42,43 or retrospective studies. 44 Taking the lack of consensus in the literature and our study results into account, we suggest a cautious rehabilitation plan for patients taking these medications until stronger evidence is available 45 and the effects of short-versus long-term treatment or intravenous versus oral administration are clarified. 46 Study limitations include the study being performed in a single center and the retrospective design.…”

“Bisphosphonates: Possible Modes of Action and Implications for Dental Implant Treatment. A Review of the Literature”

“…Bisphosphonate Related Osteonecrosis of the Jaws (BRONJ) has been defined as an area of bone exposure in the maxilla-facial region that did not heal within 8 weeks after diagnosis by a health care provider, in a patient who was receiving or had been exposed to a bisphosphonate without a history of radiation therapy to the head and neck [25,36,[130][131][132][133][134][135].…”

Influência Do Uso De Bisfosfonatos Em Pacientes Submetidos a Implantes Dentários: Revisão Da Literatura

“…(21,23) Existe também evidências limitadas sobre o desenvolvimento de ONMB decorrentes da ação do efeito de outros fatores de risco, tais como a potência do fármaco utilizado, a duração da terapia, a idade avançada, estado odontogênico e periodontal, corticoterapia concomitante, doenças sistêmicas como diabetes e tabagismo. (23) Corroborando com alguns autores, (23) a eleição de duas bases de dados somente e a adição de artigos exclusivamente em língua inglesa, foram fatores limitantes dos resultados, (23) acredita-se também ser este um fator chave limitante na presente pesquisa. Todas estas conclusões justificam a necessidade de novas pesquisas.…”