Dental Implants in Patients With Osteoporosis

Abstract

Osteoporosis is a systemic disorder characterized by generalized decrease in bone mineral density. Dental implantology is a specialty with high predictability when both quantity and quality of the bone are respected. Therefore, the diagnosis and the implant treatment in patients with osteoporosis are important. In the current study, a literature review about osteoporosis and dental implant therapy was conducted. PubMed, Cochrane, ISI, Dentistry Oral Science, SciELO, and Bireme databases were consulted over the last 20 years. English- and Portuguese-language articles were included in this revision. Some authors stated that the osteoporotic bone is similar to the proposed model of bone type IV. Randomized clinical studies reported implant failure in patients with osteoporosis after menopause. Studies that contraindicate the use of implants in patients with osteoporosis infer that the impaired bone metabolism led to reduction of bone healing around the implants. Nevertheless, other authors believe that the presence of osteoporosis is not a definitive condition to contraindicate the therapy with dental implants. In these cases, the dentist should perform a proper treatment planning, modifying the implant geometry, and use larger implant diameter and with surface treatment. Thus, osteoporosis is not a contraindication for implant surgery because an accurate analysis of bone quality by means tomography is performed.

Dental implants in patients affected by systemic diseases

“…Osteoporotic bone can be regarded as equivalent to Type IV according to Lekholm and Zarb classification 28 and, according to the limited available evidence, the clinician may also consider to allow a longer healing period for osseointegration before the prostheses' insertion. 29 Currently, immediate loading is not recommended and it is plausible to expect an increased risk of complications in case bone augmentation procedures are required. [30][31][32] Medications-related osteonecrosis of the jaws (MRONJ) A potential issue in osteoporotic patients is the possibility that antiresorptive medications, like bisphosphonates (BP) or denosumab, may interfere with bone turnover at the dental implant interface, reducing implant success and increasing the risk of developing osteonecrosis of the jaws (ONJ).…”

The Effects of Hyperlipidemia on Implant Osseointegration in the Mouse Femur

“…The effects of hyperlipidemia on bone health may also interfere with dental implant therapy since the host’s bone quantity, quality and healing potential play an important role in osseointegration(Fedele, Sabbah et al 2011; Gaetti-Jardim, Santiago-Junior et al 2011; Olivares-Navarrete, Raines et al 2012). Currently, the role of hyperlipidemia in implant osseointegration is unknown.…”

Study of a new bone-targeting titanium implant–bone interface

“…[1][2][3][4] Many clinicians and researchers have observed that bone regeneration and biomaterial osseointegration are slower in osteoporotic subjects, with an increased rate of prosthetic device failure in both dental and orthopedic reconstructive surgery. [5][6][7] Different strategies have been proposed to improve implant-bone interfaces on mainstream titanium (Ti) and Ti alloy implants, including the manipulation of surface topography, application of biomimetic coatings, and local delivery of drugs to enhance bone formation or inhibit bone resorption.…”