Outcome and Survival of Dental Implants in Patients with Bisphosphonate Therapy

The goal of this study is to find out the rate of survival of dental implants among patients with the history of bisphosphonate (BP) therapy. This study is also intended to investigate the other possible outcomes of dental implants placement in those patients such as the incidence of BRONJ (Bisphosphonates-related osteonecrosis in the jaws) development and marginal bone loss in the successfully osseointegrated dental implants. 23 articles that fulfilled the inclusion and exclusion criteria which published from year 2006 to 2017 were selected after the exploration of articles through the PubMed database. 23 articles were involved in the investigation of success rate of dental implants among BPs related patient whereas only 5 of them measured the amount of marginal bone resorption in those successfully placed dental implants. Most of the studies showed more than 90% success rate of dental implants among the group of patients with oral BPs without BRONJ development. However, almost all BRONJ cases reported in the studies involved patients who were taking intravenous BP had common BRONJ site in the posterior mandible. The period of clinical manifestation of BRONJ in such patient can be as short as 2 months. Some studies suggested that BRONJ is accelerated in cases with dental implants surgery performed during or after BP therapy. 5 studies showed a range of marginal bone resorption of 1-3 mm in the successfully osseointegrated dental implants.
Dental implant surgery did not absolutely contraindicate in patients who were taking BPs and this procedure is relatively safe to perform in patients taking oral BP. However dental implant surgery has to be performed cautiously among patients with intravenous BP due to the possible risk of devastating BRONJ development.