Potential Applications of Biphosphonates in Dental Surgical Implants

Abstract

Biphosphonates are largely used for their unquestionable properties of inhibiting bone resorption by osteoclasts in the treatment of various osteometabolic illnesses such as osteoporosis, multiple myeloma, tumors which metastasize to the bone and malignant hypercalcemia. In this literature review the physico-chemical properties, biologic activities and the mechanisms of action of biphosphonates are described. The use of these drugs is discussed, analyzing the quantity of results which have emerged through in vitro and in vivo experiments on animal models. In this study the efficiency of these drugs is demonstrated in contrasting the osteolitic processes of the alveolar bone, in promoting the neoformation and in bettering the quality of bone implants. However, it is important to draw attention to a worrying correlation which has emerged during the last 3-4 years, between osteonecrosis of the jaw (ONJ) and the systemic administration of aminobiphosphonates. This collateral effect did not emerge following the use of non-aminobiphosphonates. The aim of this review is to identify the guidelines for the use of biphosphonates in oral implant surgery.

Do topical applications of bisphosphonates improve bone formation in oral implantology? A systematic review

“…The study included 15 rabbit calvaria bone defects. Four defect groups were created in each rabbit calvaria: ( 1 ) untreated bone defect; ( 2 ) PLGA only; ( 3 ) 2 mg of pamidronate with PLGA; and ( 4 ) 3 mg of pamidronate with PLGA. In radiographic analysis, radiopacity was lower in pamidronate groups at 1, 2, 4, 6 and 8 weeks after surgery.…”

“…Non-amino-bisphosphonates, such as clodronate and etidronate, inhibit bone resorption primarily by inducing osteoclast apoptosis through the formation of intracellular metabolites in osteoclasts. Amino-bisphosphonates, such as pamidronate, alendronate or zoledronate, offer greater potency through the addition of a primary amino-nitrogenated base (-NH2) ( 3 , 4 ). These act by inhibiting farnesyl diphosphate (FPP) synthase, a key enzyme in the mevalonate pathway ( 5 ).…”

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

“…The theory behind this positive effect is that once bisphosphonates are released from the surface of the coated implant, there is a localized reduction in osteoclastic activity, altering the balance of bone remodeling in favour of increased osteoblastic activity, leading to increased bone formation which in turn increases the local bone density [197,198]. The authors hope that this improved early fixation may reduce the rate of late implant failures and could also allow earlier loading times.…”

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

“…The estimated prevalence of BRONJ in patients treated with oral bisphosphonates was 0.89% [70]. Furthermore, recent studies used oral bisphosphonates to assess the osteointegration of dental implants; some authors reported that clodronate could be useful in the maintenance of primary stability [71][72][73]. Zuffetti, et al administred a 3% clodronate solution mixed with a surfactant (Tween-20) at a 1:3 ratio both at the implant surface and at the implant site, reporting that oral BPs may positively affect implant survival in the preloading and postloading phases in partially and fully edentulous patients [74].…”