Osteopathology induced by bisphosphonates and dental implants: clinical observations

Jacobsen, Christine; Metzler, Philipp; Rössle, Matthias; Obwegeser, Joachim A.; Zemann, Wolfgang; Grätz, K W

doi:10.1007/s00784-012-0708-2

Cited by 96 publications

(121 citation statements)

References 37 publications

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“…Mínguez-Serra, et al [40] suggested the avoidance of dental implant procedures in patients that have been receiving intravenous BPs. This is in accordance with several studies where it has been shown that the combined use of oral and intravenous BP, have determined cases of osteonecrosis [41][42][43].…”

Section: Oral Bisphosphonatessupporting

confidence: 78%

“…et al [40] suggested the avoidance of dental implant procedures in patients that have been receiving intravenous BPs. This is in accordance with several studies where it has been shown that the combined use of oral and intravenous BP, have determined cases of osteonecrosis [41][42][43].The estimated incidence of orally administered bisphosphonates related osteonecrosis of the jaws for patient treated with weekly alendronate is 0.01 to 0.04% [44]; furthermore, when administered intravenously, bisphosphonate loads bone and accumulates in bone 142.8 times faster than when administered orally [45]. For this reason, dental implant placement is not contraindicated in patients taking oral bisphosphonates, but oral surgical procedures are considered the major risk factor of development of ONJ in patients under therapy with this drugs [46].…”

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confidence: 75%

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Dental Implants in Osteoporotic Patients Taking Oral Bisphophonates: A Literature Review

Nuti¹

2017

Austin J Dent

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Objective: Osteoporosis is a systemic disorder characterized by generalized decrease in bone mineral density that can eventually result in fragility fracture. Bisphosphonates have been used in the treatment of osteoporosis for many years in order to inhibit bone resorption. Unfortunately, the use of bisphosphonates has been found to be associated with several adverse events in patients where dental pathologies were present. For this reason, an increased attention has been recommended in those patients where bisphosphonates have been assumed and where dental therapies are mandatory. The aim of this article is to focus on the aspects of implant therapy in patients under bisphosphonates treatment and to produce a bibliographic review of dental implants placed in osteoporotic/osteopenic patients under treatment with oral bisphosphonates. Materials and Methods:The literature review was performed on PUBMED, MEDLINE using as search terms: oral bisphosphonates, dental implants, osteoporosis/osteopenia, osteonecrosis of the jaws (ONJ). Conclusions:In conclusion the analysis of the studies shows that the therapy with oral bisphosphonates does not affect osteointegration of dental implants and in most cases determines a low risk of ONJ. Keywords: Oral bisphosphonates; Dental implants; Osteoporosis/ osteopenia; Osteonecrosis of the jaws (ONJ) IntroductionOsteoporosis is a systemic skeletal disorder characterized by skeletal fragility, and macro/micro-architectural modifications [1]. Osteoporosis is one of the most common chronic diseases referred in 1/3 postmenopausal women and 1/5, men over the age of 50 years (European Parliament Osteoporosis Interest Group and EU Osteoporosis Consultation Panel 2004) [2]. For example in Europe, the USA and Japan, osteoporosis is estimated to affect 75 million people [3] ; currently, it is estimated that over 200 million people worldwide suffer from this disease, and the incidence of osteoporosis increases exponentially after the age of 50 [4] . In fact one third of women and one-fifth of men over 50 had experienced osteoporotic fractures [5,6]. The risk of hip, forearm and vertebrae fracture is approximately 40% the same as the risk of cardiovascular disease [6]. According to some authors, 40% of women [7,8] or 50% of women over 50 [9] and up to 29% of men may sustain an osteoporotic fracture. A higher prevalence of fragility fractures has been described in white populations [10], especially in non Hispanic-Caucasians [11]; lower rates have been found among black populations [10]. In Europe, the Scandinavian countries have the highest prevalence of fragility fractures [12]. Although it is widely recognized that low bone mass is not the only determinant of bone fragility, the strength of the skeleton is influenced by other bone tissue properties, collectively named "bone quality" [13,14]. The mean change of bone remodelling pattern in osteoporosis patients resulted in perforation of trabecular plates and loss of cancellous trabecular elements with consequent bone mineral densit...

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Section: Oral Bisphosphonatessupporting

confidence: 78%

supporting

confidence: 75%

Dental Implants in Osteoporotic Patients Taking Oral Bisphophonates: A Literature Review

Nuti¹

2017

Austin J Dent

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“…There was a mean duration of 16 months from implants placement until the appearance of BRONJ [ 127 ]. In another series of BRONJ following dental implants, again involving patients on bisphosphonates either orally or intravenously, it has been suggested that posteriorly placed implants seem to be at higher risk of BRONJ development [ 128 ]. BRONJ is a real issue for patients treated with intravenous bisphosphonates, but the occurrence of BRONJ in patients receiving oral bisphosphonates medication is minimal [ 1 ].…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

Examination and Diagnosis

2016

Clinical Cases in Implant Dentistry

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“…There have been several case reports and series that have evaluated implant failures in patients receiving intravenous bisphosphonate therapy [180], while other retrospective studies have indicated that there may be risks of osteopathology developing in patients receiving oral bisphosphonates and dental implant treatment [10][11][12][13][14]. While BRONJ is an important potential complication that may lead to implant failure it is important to distinguish that implant failure may also occur without the presence of any clear pathology due to a loss of osseointegration in patients being treated with bisphosphonates.…”

Section: Bisphosphonates and Dental Implantsmentioning

confidence: 99%

“…Intravenous bisphosphonate therapy for underlying malignant disease seems to be a clear contraindication for the placement of dental implants, whereas implants can be placed in patients receiving oral bisphosphonates for the treatment of osteoporosis [180].…”

Section: Bisphosphonates and Dental Implantsmentioning

confidence: 99%

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

Ballantyne¹

2016

J Gen Pract

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Osteopathology induced by bisphosphonates and dental implants: clinical observations

Abstract: Objectives Although there are many reports about risk factors for

Cited by 96 publications

References 37 publications

Dental Implants in Osteoporotic Patients Taking Oral Bisphophonates: A Literature Review

Dental Implants in Osteoporotic Patients Taking Oral Bisphophonates: A Literature Review

Examination and Diagnosis

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

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