Low Skeletal Bone Mineral Density Does Not Affect Dental Implants

The aim of this case-control study (n = 30) was to evaluate the effects of osteoporosis/osteopenia on the success of dental implants. Twenty healthy females ages 50-80 with confirmed osteoporosis or osteopenia, and 10 age- and gender-matched subjects with normal bone density (controls) received dental implants. Dual-energy X-ray absorptiometry (DXA) scans at 5 standard sites (total body, hip, spine [lateral and anterior-posterior] and radius) were measured at baseline and 24 months. Periapical and panoramic radiographs were taken at baseline before implant placement; 1 periapical radiograph was taken immediately after placement of the dental implant. Since implants are standard sizes, periapical bone loss was measured from the first implant thread to the level of alveolar bone at baseline, 12 months, and 24 months via 1 periapical radiograph. All subjects received implants of the same manufacturer (NobelBiocare). One subject was a smoker. Three subjects with osteoporosis had received prior treatment with Fosamax, 1 received Fortical, and 1 Forteo. In all 3, there was slight improvement in DXA after 24 months. All implants remained successful with no evidence of bone loss after 24 months. These investigators conclude that implants placed in individuals with confirmed skeletal osteoporosis can be successful, with no clinical differences to implants placed in healthy individuals. Although 3 subjects with osteoporosis had treatment with oral bisphosphonates, no side effects were noted and no bone necrosis of the jaw was observed. Further investigation with larger sample sizes and longer periods of time for treatment with oral bisphosphonates is recommended to confirm these results.