Review Article

Osseointegration of dental implants in patients with oral bisphosphonate intake: a review

Abstract

Introduction: Bisphosphonates are  widely used  for  various bone  diseases including osteoporosis and bone tumors. One of the complications associated with these pharmaceutical agents is bisphosphonate-related osteonecrosis of the jaw. This condition may be triggered by placement of dental implants. In turn,  osteonecrosis  of  the  jaw  may  cause  failure  in  osseointegration  of implants. Moreover, bisphosphonates can influence osseointegration of dental implants by alteration of bone turnover. The aim of this study was to review the published articles on osseointegration of dental implants in patients taking oral bisphosphonates.Material   and   Methods:   PubMed/Medline   database   was   searched   for published articles until 31 January 2014 using “osseointegration” and “bisphosphonate”   as   keywords.   Inclusion   criteria   were   human   studies including case  series,  retrospective studies  and  prospective  studies  on  the subject.  Exclusion  criteria  were  case  reports,  intravenous  bisphosphonate intake, and placement of implants in other parts of the body rather than jaws.Results: A total of 66 articles were evaluated at abstract level. Eventually 4 articles  were  chosen  including  nearly  1470  patients  taking  oral bisphosphonates. Failure in osseointegration of dental implants or its loss was observed in 23 patients. This shows failure in integration between bone and implant in approximately 1 out of 64 patients taking oral bisphosphonates. Accordingly impaired osseointegration was observed in 1.44% of patients with bisphosphonate intake.Conclusion: Although failure in osseointegration of dental implants in patients with bisphosphonate intake is unlikely, the risk of failure should be considered in treatment planning for these patients and utmost care should be employed to prevent possible complications.

Fleisch H. Bisphosphonates in bone disease: from the laboratory to the patient: Elsevier; 2000.

Fleisch H, Graham R, Russell G, Francis MD.Diphosphonates inhibit hydroxyapatite dissolution in vitro and bone resorption in tissue culture and in vivo. Science.1969;165(3899):1262-4.

Dunford JE, Thompson K, Coxon FP, Luckman SP, Hahn FM, Poulter CD, et al. Structure- activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonates. J Pharmacol ExpTher.2001;296(2):235-42.

Francis MD, Graham R, Russell G, Fleisch H.Diphosphonates inhibit formation of calcium phosphate crystals in vitro and pathological calcification in vivo. Science.1969;165(3899):1264-6.

Sahni M, Guenther HL, Fleisch H, Collin P, Martin TJ. Bisphosphonates act on rat bone resorption through the mediation of osteoblasts. J Clin Invest. 1993;91(5):2004.

Nishikawa M, Akatsu T, Katayama Y, Yasutomo Y, Kado S, Kugai N, et al. Bisphosphonates act on osteoblastic cells and inhibit osteoclast formation in mouse marrow cultures. Bone.1996;18(1):9-14.

Adami S, Passeri M, Ortolani S, Broggini M, Carratelli L, Caruso I, et al. Effects of oral alendronate and intranasal salmon calcitonin on bone mass and biochemical markers of bone turnover in postmenopausal women with osteoporosis. Bone. 1995;17(4):383-90.

Bartl R, Frisch B, von Tresckow E, Bartl C.Bisphosphonates in Medical Practice: Actions- Side Effects-Indications-Strategies: Springer;2007.

McLeod NMH, Brennan PA, Ruggiero SL.Bisphosphonate osteonecrosis of the jaw: A historical and contemporary review. The Surgeon. 2012;10(1):36-42.

Yarom N, Yahalom R, Shoshani Y, Hamed W, Regev E, Elad S. Osteonecrosis of the jaw induced by orally administered bisphosphonates:incidence, clinical features, predisposing factors and treatment outcome. Osteoporos Int.2007;18(10):1363-70.

Saldanha S, Shenoy VK, Eachampati P, Uppal N. Dental implications of bisphophonate‐related osteonecrosis. Gerodontology. 2012;29(3):177-87..

Garetto LP, Chen J, Parr JA, Roberts WE.Remodeling dynamics of bone supporting rigidly fixed titanium implants: a histomorphometric comparison in four species including humans. Implant Dent. 995;4(4):235-43.

Kasai T, Pogrel M, Hossaini M. The prognosis for dental implants placed in patients taking oral bisphosphonates. J Calif Dent Assoc. 2009;37(1):39-42.

Goss A, Bartold M, Sambrook P, Hawker P.The nature and frequency of bisphosphonate- associated osteonecrosis of the jaws in dental implant patients: a South Australian case series. J Oral Maxillofac Surg. 2010;68(2):337-43.

Chadha GK, Ahmadieh A, Kumar S, Sedghizadeh PP. Osseointegration of dental implants and osteonecrosis of the jaw in patients treated with bisphosphonate therapy: a systematic review. The Journal of oral implantology. 2013;39(4):510-20.

Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61(9):1115-7.

Edwards BJ, Hellstein JW, Jacobsen PL, Kaltman S, Mariotti A, Migliorati CA, et al.Updated recommendations for managing the care of patients receiving oral bisphosphonate therapy. J Am Dent Assoc. 2008;139(12):1674-7.

Bone HG, Hosking D, Devogelaer J-P, Tucci JR, Emkey RD, Tonino RP, et al. Ten years' experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med.2004;350(12):1189-99.

Cooper LF. Biologic determinants of bone formation for osseointegration: clues for future clinical improvements. J Prosthet Dent.1998;80(4):439-49.

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IssueVol 2, No 1-2 (Winter/Spring 2015) QRcode
SectionReview Article(s)
Keywords
Bisphosphonate Osseointegration Dental implant

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How to Cite
1.
Moaddabi A, Shariati M, Hossein-Moaddabi A, Soltani P. Osseointegration of dental implants in patients with oral bisphosphonate intake: a review. J Craniomaxillofac Res. 2015;2(1-2):74-77.