Osteogenetic Effect of Low-Magnitude High-Frequency Loading and Parathyroid Hormone on Implant Interface in Osteoporosis

Abstract

Osteoporosis could potentially complicate oral implant treatment because of disease-specifi c characteristics such as the abnormal bone condition, poor healing ability caused by bisphosphonates (BPs), and bisphosphonate-related osteonecrosis of the jaw (BRONJ). These problems must be resolved to ensure that oral implant treatment is successful in osteoporotic patients.As a novel therapeutic option for increasing the success rate of oral implantation in patients with osteoporosis, we focused on parathyroid hormone (PTH) and lowmagnitude high-frequency (LMHF) loading. Compared to BPs, which inhibit osteoclastic bone resorption and suppress bone turnover, PTH stimulates osteoblastic bone formation and promotes bone turnover. Intermittent PTH administration is a new class of anabolic therapy for the treatment of severe osteoporosis. LMHF loading, which elicits a positive effect on skeleton, has been proposed as a nonpharmacological and adjunctive intervention in the treatment of osteoporosis. Previous investigation reported that both intermittent PTH administration and LMHF loading have an independent osteogenic effect on peri-implant bone healing and implant osseointegration. In addition, our recent study reveals their combined therapy acts locally and synergistically on peri-implant bone healing process, strengthening osseointegration.Therefore, this can be a new therapeutic option for oral implant treatment in osteoporotic patients without any problems.