Skip to main content Skip to main navigation menu Skip to site footer
MedNext Journal of Medical and Health Sciences
Review
DOI: 10.54448/mdnt23S107
Submitted: 17-02-2023
Published: 17-02-2023

Atrophic maxilla and osseointegrated implants: a systematic review

UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
UNORTE - University Center of Northern São Paulo, Dentistry department, São José do Rio Preto, São Paulo, Brazil / UNIPOS - Post graduate and continuing education, Dentistry department, São José do Rio Preto, São Paulo, Brazil
Atrophic maxilla Dental implant Bisphosphonate Osseointegration Osteoporosis

Abstract

Introduction: In the scenario of the dental implants, what makes implantology unique is the ability to achieve this goal, however, the more teeth a patient loses the more challenging the task becomes. Osteoporosis may be a risk factor for the use of implants. Alternative approaches such as guided surgery and placement of short implants are progressively supplanting more invasive bone regeneration procedures. There are some drugs that help in the treatment of postmenopausal osteoporosis, they are calcitonin, bisphosphonates and the selective modulators of estrogen receptors. Objective: Foi realizar uma revisão sistemática sobre as principais considerações e desfechos clínicos da maxila atrófica no cenário dos implantes dentários osseointegrados, osteoporose e o uso dos bifosfonatos. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October 2022 to January 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2005 to 2022. 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 225 articles were found, and 65 articles were evaluated in full and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 45 studies with a high risk of bias and 90 studies that did not meet GRADE. In the scenario of atrophic maxilla issues, it was concluded that osteoporosis is a metabolic condition that affects alveolar bone density, but does not present problems for the installation of osseointegrated implants, provided there is enough bone mass in the region where the tooth will be implanted. The rehabilitation of atrophic maxilla through dental implants is still challenging, however, alternatives such as guided surgery and the installation of short implants are progressively supplanting the more invasive bone regeneration procedures. Some drugs that help in the treatment of postmenopausal osteoporosis, are calcitonin, bisphosphonates, and the selective modulators of estrogen receptors. Bisphosphonates have been the best drug associated with significant improvement in the quality of life of patients with bone diseases such as Paget's disease, bone metastases, osteogenesis imperfecta, hypercalcemia, and even severe osteoporosis.

Metrics

Metrics Loading ...

References

  1. Zaninovich M. Immediate Rehabilitation of the Severely Atrophic Maxilla Using TransSinus Nasal Protocol and Extended Length Subcrestal Angulated Implants. Case Series With 1-Year Follow-Up. J Oral Implantol. 2022 Apr 1;48(2):117-124. doi: 10.1563/aaid-joi-D-19-00307.
  2. Wu J, Liu K, Li M, Zhu ZJ, Tang CB. Clinical assessment of pterygoid and anterior implants in the atrophic edentulous maxilla: a retrospective study. Hua Xi Kou Qiang Yi Xue Za Zhi. 2021 Jun 1;39(3):286-292. English, Chinese. doi: 10.7518/hxkq.2021.03.007.
  3. Urban IA, Monje A, Lozada JL, Wang HL. Long-term Evaluation of Peri-implant Bone Level after Reconstruction of Severely Atrophic Edentulous Maxilla via Vertical and Horizontal Guided Bone Regeneration in Combination with Sinus Augmentation: A Case Series with 1 to 15 Years of Loading. Clin Implant Dent Relat Res. 2017 Feb;19(1):46-55. doi: 10.1111/cid.12431.
  4. 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.
  5. 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.
  6. 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.
  7. Torres J, Tamimi F, García I, Cebrian JL, López-Cabarcos E, Lopez A. Management of atrophic maxilla in severe osteoporosis treated with bisphosphonates: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Nov;106(5):668-72. doi: 10.1016/j.tripleo.2008.03.008.
  8. Meirelles MS, de Almeida DCF, Velloso GR, Torres M, Sartoretto SC, Moraschini V. Atrophic Maxilla Rehabilitation Through Dental Implants Using the V-4 Strategy Associated With Guided Surgery: A Case Report and Technique Description. J Oral Implantol. 2021 Dec 1;47(6):498-501. doi: 10.1563/aaid-joi-D-20-00121.
  9. 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.
  10. 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.
  11. 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., 2007, v.28, n.1, p.77-83.
  12. 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.
  13. Lombardo G, Signoriello A, Marincola M, Liboni P, Faccioni P, Zangani A, D'Agostino A, Nocini PF. Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study. Materials (Basel). 2022 Nov 12;15(22):7995. doi: 10.3390/ma15227995.
  14. Yücesoy T, Göktaş TA. Evaluation of Sinus Pneumatization and Dental Implant Placement in Atrophic Maxillary Premolar and Molar Regions. Int J Oral Maxillofac Implants. 2022 March/April;37(2):407–415. doi: 10.11607/jomi.9215.
  15. Ferreira Júnior CD, Casado PL, Barboza ESP. Osteonecrose Associada aos Bisfosfonatos na Odontologia. R. Periodontia. 2007, v.1, n.4, dez.
  16. Sivrikaya EC, Yilmaz O. Comparison of Extramaxillary Anchored Implants, Tilted Implants, or Sinus Elevation Concepts on Stress Distribution in Atrophic Maxilla: A Finite Element Analysis. Int J Oral Maxillofac Implants. 2022 May-Jun;37(3):563-570. doi: 10.11607/jomi.9631.
  17. Ishii JH. Osteoporose e os Implantes Dentários. São Paulo, 2009. 24 p.
  18. Schiegnitz E, Hill N, Sagheb K, König J, Sagheb K, Al-Nawas B. Short versus Standard Length Implants with Sinus Floor Elevation for the Atrophic Posterior Maxilla. Acta Stomatol Croat. 2022 Jun;56(2):143-153. doi: 10.15644/asc56/2/5.
  19. Martins MAT et al. Osteonecrose dos Maxilares Associada ao Uso de Bifosfonatos: Importante Complicação do Tratamento Oncológico. Rev. Bras. Hematol Hemoter 2009; 31(1):41-46.
  20. Migliorati CA 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).
  21. Misch CE. Implantes Dentais Contemporâneos. Rio de Janeiro: Elsevier. 2008, 3nd.
  22. Ourique SAM, Ito AY, Suarez OF. Osteoporose em Implantodontia: O Estado Atual da Questão. Rev. Bras. Implantodontia e Prótese sobre Implantes, 2005: 12(47/48): 237- 45.
  23. 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.
  24. 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.
  25. 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.
  26. 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.
  27. 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.
  28. 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.
  29. 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.
  30. 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.
  31. 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

Pinos, R. A. M., Palácios, A. J. P., Idalgo, F. A., & Fornazari, W. A. G. (2023). Atrophic maxilla and osseointegrated implants: a systematic review. MedNEXT Journal of Medical and Health Sciences, 4(1). https://doi.org/10.54448/mdnt23S107