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MedNext Journal of Medical and Health Sciences
Review
DOI: 10.54448/mdnt22S404
Submitted: 07-12-2022
Published: 07-12-2022

Benefits and harmfulness of the use of bisphosphonate in the osseointegration process for dental implants in patients with osteoporosis: a concise systematic review

UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
UNORTE - University Center of Northern São Paulo - Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, Sao Jose do Rio Preto, Sao Paulo, Brazil
Dental implants Osteoporosis Bisphosphonate Osseointegration Osteonecrosis

Abstract

Introduction: In the scenario of implantology and osteoporosis, it is highlighted that the high need and use of treatments related to dental implants result from the combined effect of several factors, highlighting aging and bone fragility. In this context, osteoporosis is a global bone disease prevalent in human aging. Bisphosphonates (BPs) are commonly used as therapy because they influence hard and soft tissue calcium metabolism. Objective: It was to present the main considerations and scientific evidence of the use of bisphosphonate in the osseointegration process for dental implants in patients with osteoporosis, as well as to emphasize the harm caused by the occurrence of osteonecrosis. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from February 2022 to May 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 110 articles were found. In total, 58 articles were fully evaluated and 28 were included and evaluated in this study. Of the initial total of articles, 26 articles were excluded because they did not meet the GRADE classification, and 4 were excluded because they presented a risk of bias. It was concluded that osteoporosis is a metabolic condition that affects alveolar bone density, which may compromise the dental implant process. Therefore, the careful use of bisphosphonates is necessary for the osseointegration process, however, dental surgeons are encouraged to know the diagnosis so that they can make a careful assessment, observing the quality of the bone through routine imaging exams, to prevent osteonecrosis. In addition, alendronate sodium is used to decrease bone resorption, being an adjuvant therapeutic agent for the treatment of osteoporosis.

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References

  1. Sher J, Kirkham-Ali K, Luo JD, Miller C, Sharma D. Dental Implant Placement in Patients With a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review. J Oral Implantol. 2021 Jun 1;47(3):249-268. doi: 10.1563/aaid-joi-D-19-00351. PMID: 32699903.
  2. Otto S, Schnoedt EM, Troeltzsch M, Kaeppler G, Aljohani S, Liebermann A, Fliefel R. Clinical and Radiographic Outcomes of Dental Implants in Patients treated with Antiresorptive Drugs: A Consecutive Case Series. J Oral Implantol. 2022 Apr 21. doi: 10.1563/aaid-joi-D-21-00035. Epub ahead of print. PMID: 35446931.
  3. Touyz LZG, Afrashtehfar KI. Implications of bisphosphonate calcium ion depletion interfering with desmosome epithelial seal in osseointegrated implants and pressure ulcers. Med Hypotheses. 2017 Sep;107:22-25. doi: 10.1016/j.mehy.2017.07.013. Epub 2017 Jul 18.
  4. Pogrel MA, Ruggiero SL. Previously successful dental implants can fail when patients commence anti-resorptive therapy-a case series. Int J Oral Maxillofac Surg. 2018 Feb;47(2):220-222. doi: 10.1016/j.ijom.2017.07.012. Epub 2017 Aug 10.
  5. Chrcanovic BR, Albrektsson T, Wennerberg A. Bisphosphonates and dental implants: A meta-analysis. Quintessence Int. 2016 Apr;47(4):329-42. doi: 10.3290/j.qi.a35523.
  6. Basso FG, Pansani TN, Soares DG, Cardoso LM, Hebling J, de Souza Costa CA. Influence of bisphosphonates on the adherence and metabolism of epithelial cells and gingival fibroblasts to titanium surfaces. Clin Oral Investig. 2018 Mar;22(2):893-900. doi: 10.1007/s00784-017-2167-2. Epub 2017 Jul 8.
  7. Gelazius R, Poskevicius L, Sakavicius D, Grimuta V, Juodzbalys G. Dental Implant Placement in Patients on Bisphosphonate Therapy: a Systematic Review. J Oral Maxillofac Res. 2018 Sep 30;9(3):e2. doi: 10.5037/jomr.2018.9302. eCollection 2018 Jul-Sep.
  8. Camargo EP, Minosso M, Lopes LC. Caracterização do Uso de Alendronato de Sódio no Tratamento de Osteoporose por Clínicos da Rede Privada de Duas Cidades do Interior de São Paulo. Rev. Ciênc. Farm. Básica Apl., v.28, n.1, p.77-83, 2007.
  9. Carvalho PSP. et al. Principais Aspectos da Cirurgia Bucomaxilofacial no Paciente sob Terapia com Bifosfonatos. RFO UPF [online]. 2010, vol.15, n.2, pp. 183-189. ISSN 1413-4012.
  10. Duarte PM, Nociti Júnior FH. Impacto da Deficiência de Estrógeno e suas Terapias sobre o Tecido Ósseo ao Redor de Implantes de Titânio e na Periodontite Induzida em Ratas Ovariectomizadas. Tese (Doutorado) – Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba. Piracicaba, 2004. XVII, 131p.
  11. Embracher Filho, A. Projeto Colosso: Desenvolvimento de um sistema de implante osseointegrável. Da teoria a prática. Tese (Doutorado) - Faculdade de Odontologia de Araçatuba, UNESP, 2003.
  12. Ferreira Júnior, C. D; Casado, P. L.; Barboza, E. S. P. Osteonecrose Associada aos Bisfosfonatos na Odontologia. R. Periodontia. v.1, n.4, dez., 2007.
  13. Gegler A. et al. Bifosfonatos e Osteonecrose Maxilar: Revisão da Literatura e Relato de Dois Casos. Rev. Brasileira de Cancerologia 2006; 52(1):25-31.
  14. Ishii, J. H. Osteoporose e os Implantes Dentários. São Paulo, 2009. 24 p.
  15. Luize, D. S. et al. A Influência da Osteoporose na Implantodontia. Arquivos em Odontologia, Belo Horizonte, v.41, n.2, p.105-192, abr./jun. 2005.
  16. Martins, M. A. T.; et al. Osteonecrose dos Maxilares Associada ao Uso de Bifosfonatos: Importante Complicação do Tratamento Oncológico. Rev. Bras. Hematol Hemoter 2009; 31(1):41-46.
  17. Migliorati, C. A.; et al. O Tratamento de Pacientes com Osteonecrose Associada aos Bifosfonatos. Uma tomada de posição da Academia Americana de Medicina Oral. J American Dental Association 2006; 136(12).
  18. Misch, C. E. Implantes Dentais Contemporâneos. Rio de Janeiro: Elsevier. 2008, 3nd.
  19. Ourique S.A.M., Ito A.Y., Suarez O.F. Osteoporose em Implantodontia: O Estado Atual da Questão. Rev. Bras. Implantodontia e Prótese sobre Implantes, 2005: 12(47/48): 237-45.
  20. Goiato MC, Santos DM, Rondon BCS, Moreno A, Baptista GT, Verri FR et al. Care Required When Using Bisphosphonates in Dental Surgical Practice. J. craniofac. surg. 2010; 21(6):1966-70.
  21. Chadha GK, Ahmadieh A, Kumar S, Sedghizaded PP. Osseointegration of dental osteonecrosis of the jaw in patients treated with bisphosphonates therapy: a systematic review. J. oral implantol. 2013;39(4):510-20.
  22. Mellado-Valero A, Ferrer-García JC, CalvoCatalá J, Labaig- Rueda C. Implant treatment in patients with osteoporosis. Med. oral patol. oral cir. bucal. 2010; 15:52-7.
  23. López-Cedrún JL, Sanromán JF, García A, Peñarrocha M, Feijoo JF, Limeres J, Diz P. Oral bisphosphonate-related osteonecrosis of the jaws in dental implant patients: a case series. Br. j. oral maxillofac. surg. 2012;51(8):874-9.
  24. Kwon T-G, Lee C-O, Park J-W, Choi S-Y, Rijal G, Shin H-I. Osteonecrosis associated with dental implants in patients undergoing bisphosphonate treatment. Clin. oral implants res. 2012; 00:1- 9.
  25. Yip JK, Borrell LN, Cho SC, Francisco H, Tarnow DP. Association between oral bisphosphonate use and dental implant failure among middleaged women. J. clin. periodontol. 2012;39:408- 14.
  26. Memon S, Weltman RL, Katancik JA. Oral Bisphosphonates: Early Endosseous Dental Implant Success and Crestal Bone Changes. A Retrospective Study. Int. j. oral maxillofac. implants. 2012;279(5):1216-22.
  27. Abtahi J, Tengvall P, Aspenberg P. A bisphosphonate-coating improves the fixation of metal implants in human bone. A randomized trial of dental implants. Bone. 2012;50(5):1148- 51.
  28. Jacobsen C, Metzler P, Rossle M, Obwegeser J, Zemann W, Gratz KW. Osteopathology induced by bisphosphonates and dental implants: clinical observations. Clin. oral investig. 2013;17:167-75.

How to Cite

Ortega, L. F. L., Cicareli, A. J., & Kassis, E. N. (2022). Benefits and harmfulness of the use of bisphosphonate in the osseointegration process for dental implants in patients with osteoporosis: a concise systematic review. MedNEXT Journal of Medical and Health Sciences, 3(S4). https://doi.org/10.54448/mdnt22S404