Bisphosphonate and Implant Dentistry - Is it Safe?

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Pharmacology

Background:

• Bisphosphonates are crucial for managing bone diseases like osteoporosis.
• Bisphosphonate therapy is linked to bisphosphonate-related osteonecrosis of the jaws (BRONJ).
• The use of dental implants in patients on bisphosphonates presents a complex clinical challenge.

Purpose of the Study:

• To review current evidence and guidelines on bisphosphonates and their effects on implant dentistry.
• To elucidate the risks and clinical considerations associated with dental implants in patients receiving bisphosphonate therapy.
• To discuss the management of patients undergoing or considering implant therapy while on bisphosphonates.

Main Methods:

• Comprehensive literature review of bisphosphonates, BRONJ, and implant dentistry.
• Analysis of risk factors, co-morbidities, and clinical presentations of BRONJ.
• Evaluation of imaging modalities for diagnosing BRONJ.
• Discussion of patient management strategies and future research directions.

Main Results:

• Bisphosphonates significantly impact bone metabolism, increasing the risk of BRONJ.
• Identifying risk factors and co-morbidities is essential for patient assessment.
• Various imaging techniques aid in the diagnosis and evaluation of BRONJ.
• Evidence-based guidelines for managing patients considering or undergoing implant therapy are emerging.

Conclusions:

• The decision regarding implant therapy in bisphosphonate users requires careful risk-benefit assessment.
• Proactive management, including patient selection and monitoring, is crucial for successful outcomes.
• Further research is needed to optimize implant success rates and minimize BRONJ incidence in this patient population.