Abstract

Dental implants to replace missing teeth considered a standard of care and usually it has 95% success rate. Most people seeking implants are part of an older population and they may have some systemic disease including osteoporosis. Osteoporosis reduces bone strength; decreases bone mineral density and cause detrition of bone tissue, resulting in increased bone fragility and risk of bone fracture.¹ There is some evidence that implant placement may be protective against alveolar bone resorption and may be protective against bone loss due to aging process. Dental implants are increasing sought by the aging population. It is necessary to look at the effect of osteoporosis and success of implant and treatment for osteoporosis with either oral or IV bisphosphonates.² Most investigations concluded that no compelling basis exist to expect osteoporosis to be a risk factor for osseointegration of dental implant. Still many questions exist about treatment of osteoporosis with either oral or IV bisphosphonates. Bisphosphonate use considered a possible risk factor for dental implant success.

Purpose: The purpose of this study was to review literature on patients with osteoporosis who were under treatment with either oral bisphosphonate or IV bisphosphonate receiving implants and determine if implant success rates within these groups were adversely affected.

Method: Systemic search using Pub Med (Medline) to look for patients with osteoporosis and taking either oral bisphosphonate or IV Bisphosphonate from January 2010 to May 2020.

Result: Initial keyword search combination yield in 730 studies with 21 additional records found through other sources. Nine studies meeting the proposed inclusion criteria were included. Six were retrospective studies, two were case series and one was a prospective study. 991 patients receiving 1,989 total implants were included.

There was no report of any side effects. There was not adequate evidence either oral or intravenous bisphosphonate had a negative effect on implant success.

Conclusion: Our review results show there was no notable reduction of success of implants on patients which had osteoporosis and were receiving bisphosphonates. Although less desirable implant success rates were seen in controls, this difference was determined to be not significant (P=0.15). Further investigation is required.

Keywords

bone cancer, osteoporosis, osteoma, hydroxyapatite crystals, oral surgery, oral medicine, oral pathology, retrospective, prospective, case control