The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

The objective of the present systematic review was to analyze research articles that compare the accuracy of panoramic imaging to cone‐beam computed tomography (CBCT) in assessing the relationship between posterior maxillary tooth roots and the maxillary sinus. A comprehensive literature search was conducted using various databases. Initial searching yielded 64 results, and after exclusion, five full‐text articles were eligible. All were cohort studies, and the CBCT and panoramic images were either obtained from a pre‐existing database or patients were recruited specifically for the study. Analysis showed that a panoramic image is sufficient for accurately detecting when the roots are at distinct distance from the sinus. However, if the roots are either laterally or medially projecting over the sinus and “just touching” it, panoramic images generally misinterpret this position, and instead make the root appear to be in the sinus. There were mixed results for when the root tip penetrates the sinus. Some studies claimed there was high agreeance between both modalities in this situation, while others had a low level of agreeance. In these situations, ordering a CBCT should be strongly considered to properly assess oral surgery risk with regard to maxillary posterior teeth.

Purpose: This study investigated the effects of bisphosphonates (BPs) namely Alendronate (ALN) and Zoledronate (ZA) on the osteogenic activity of osteoprogenitor cells cultured on titanium surfaces at therapeutic doses in order to assess if altered osteoblastogenesis could compromise osseointegration and contribute in etiopathogenesis of painful disorders like BPrelated Osteonecrosis of the Jaw (BRONJ) following implant placement. Materials and Methods: MC3T3-E1 Subclone 4 cells were utilised in this study. Therapeutic doses of ALN and ZA were calculated based off reported peak plasma concentrations. The viability, proliferation, adhesion, and mineralisation potential of cells was assessed using a LIVE/DEAD stain, alamarBlue® assay, immunofluorescence microscopy, and Alizarin Red S staining respectively. Results: Therapeutic doses of ZA negatively affected cell viability, whereas therapeutic doses of ALN significantly enhanced cell differentiation and the amount of bone formation compared to the control. Conclusions: The findings of this study may provide some insight into the pathogenesis of BRONJ developing following implant placement in patients treated with ZA and may have promising implications towards improved wound healing and osseointegration in patients treated with ALN.