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Published on: April 9, 2013
Failure risk estimates after dental implants placement associated with plasma rich in growth factor-Endoret in
Marco Mozzati1, Valentina Arata, Maurizio Giacomello
1*SIOM Oral Surgery and Implantology Center †Oral Surgery Unit, Dentistry Section, Department of Biomedical Sciences and Human Oncology, University of Turin, Turin ‡Department of Surgery and Translational Medicine, University of Milano-Bicocca §Department of Biomedical, Surgical and Dental Sciences, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milan ||Department of Health Sciences "A. Avogadro," University of Eastern Piedmont, Novara, Italy ¶Department of Surgical Sciences, University of Turin, Turin, Italy.
Abstract:
There is disagreement as to whether it is safe to place implants in patients under bisphosphonates (BPs) therapy owing to the risk for developing BP-related osteonecrosis of the jaws (BRONJ). The American Association of Oral and Maxillofacial Surgeons recommends that dental implants should be avoided in oncologic patients treated with intravenous BPs. Conversely, for patients receiving oral BPs, dental implant placement is not explicitly contraindicated even if a cautious approach is suggested. The aim of the current study was to assess the risk level as related to adverse events such as implant failure and BRONJ in a large cohort of osteoporotic patients submitted to implant placement and concomitant application of plasma rich in growth factor (PGRF)-Endoret. The clinical charts of 235 middle-aged women under oral BPs therapy for osteoporosis, who underwent positioning of 1267 dental implants, were reviewed. The implants were always positioned in association with PRGF-Endoret. The outcomes were implant failure and BRONJ. A model based on personal risk factors distribution was used for risk assessment. Sixteen implants were lost in 16 patients up to 120 months of follow-up, leading to a survival of 98.7% and 93.2% on an implant basis and patient basis, respectively. No cases of BRONJ were reported. In line with the current literature, the present data show that the risk for developing BRONJ associated to dental implant surgery remains low for patients receiving oral BPs. The use of procedures that could enhance and support healing, such as platelet concentrates, should be recommended.
