Osseointegration of Dental Implants and Osteoporosis

Abstract

Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and susceptibility to fractures. Osteoporosis also results in loss of bone mineral density throughout the body, including the maxilla and mandible. Successful osseointegration of dental implants is attributed to their ability to integrate well with bone. The influence of bone quality on dental implant osseointegration has been discussed in several studies, and higher rates of dental implant failure have been reported in patients with low bone quality and an inadequate bone volume. Osteoporosis represents a risk factor for osseointegration, and this relationship may be derived from the association of the disease with a deficiency in bone formation. This condition would compromise the healing capacity and the apposition of bone at the implant interface. Currently, there is no clear consensus regarding dental implant treatment in osteoporotic individuals. Studies have revealed contradictory reports regarding the success and failure of dental implants in patients with osteoporosis. Antiresorptive agents have been widely used to treat osteoporosis. Dental implant placement in patients on bisphosphonate therapy may trigger osteonecrosis of the bone. Hence, it is important to analyze factors that have to be taken into consideration prior to implant therapy in patients with osteoporosis and those undergoing treatment. This chapter outlines dental implant osseointegration under osteoporotic conditions. The possible effect of bisphosphonate therapy on dental implant survival will also be discussed based on the current literature.

Avoiding implant‐related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress

“…There are no reported contraindication for implant placement in patients with osteoporosis. However, the healing process of bone tissue might take longer and the low quality of bone could affect primary stability and consequently osseointegration 69 . There are no studies that provide indications on the exact healing time in these cases, but generally a 50% increase in the standard waiting times should be sufficient.…”

“…However, the healing process of bone tissue might take longer and the low quality of bone could affect primary stability and consequently osseointegration. 69 There are no studies that provide indications on the exact healing time in these cases, but generally a 50% increase in the standard waiting times should be sufficient. Choosing to under-prepare the implant site or using a wider implant than in an ordinary situation may be beneficial.…”

Updating on dental implant osseointegration and survival rate in osteoporotic bone

“…3 Osteoporosis is characterized by a decrease in bone thickness, changes in trabecular bone structure and increase in the ratio of carbonate to phosphate so that the bone becomes susceptible to fracture. 4 Based on the World Health Organization, the diagnosis of osteoporosis is established based on the value of bone mineral density (BMD) -2,5 < Tscore < -1.0. 5 Osteoporosis is classified into primary and secondary osteoporosis, type I primary osteoporosis is closely related to low levels of estrotrogen in postmenopausal women.…”