The Nature and Frequency of Bisphosphonate-Associated Osteonecrosis of the Jaws in Dental Implant Patients: A South Australian Case Series

Goss, Alastair N.; Bartold, P. Mark; Sambrook, Paul; Hawker, Peter

doi:10.1016/j.joms.2009.09.037

Cited by 73 publications

(81 citation statements)

References 14 publications

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“…For example Wang, et al showed a case of BRONJ in one of the five mandibular implants in a patient who had taken alendronate orally for a period of more than ten years [70]. Similarly Marx, et al reported two cases of osteonecrosis resulting from implant surgery in patients who had taken bisphosphonates orally over periods of more than three years [61].…”

Section: Discussionmentioning

confidence: 99%

“…A large survey of 46 dentists in South Australia gathered information on about 28, 000 implants in 16, 000 patients over a 10-year period. 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].…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Nuti¹

2017

Austin J Dent

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“…The statistical requirements for a study to be relevant were well explained in a recent study by Goss et al [15]. Statistically, if an adverse event occurs at a rate of 1 in 100 and a statistical level of significance of P = .05 is required, then a very large study population is needed, over 10,000 patients, to achieve statistical significance.…”

Section: Types Of Studymentioning

confidence: 99%

“…Given that bisphosphonates significantly reduce bone turnover, there is a possibility that patients taking bisphosphonates may have problems with integration occurring during the osteoconductive phase or, if the implants are already successfully integrated, the reduced bone remodelling and bone turnover may result in a potential for loss of integration [15].…”

Section: Peri-implant Hard Tissue Healingmentioning

confidence: 99%

“…Bisphosphonates (BP) have been commonly used over the past 40 years to treat osteoporosis, Pagets' disease, hypercalcemia of malignancy, osteolytic lesions of multiple myeloma and bone metastases associated with breast, prostate, lung and other soft tissue tumours [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. They are potent osteoclast inhibitors and are considered the drug of choice for the treatment of diseases affecting bone metabolism [5,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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