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Bisphosphonates and dental implants: A meta-analysis.

Bruno Ramos Chrcanovic, Tomas Albrektsson, Ann Wennerberg

    Quintessence International (Berlin, Germany : 1985)
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    Summary
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    Bisphosphonates may increase dental implant failure rates, though evidence is limited. More specific studies are needed to confirm the effect of bisphosphonates on implant survival and osseointegration.

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    Area of Science:

    • Oral Surgery
    • Biomaterials Science
    • Pharmacology

    Background:

    • Bisphosphonates (BPs) are commonly prescribed for osteoporosis and other bone conditions.
    • The impact of BPs on dental implant success remains a subject of ongoing research and clinical debate.

    Purpose of the Study:

    • To evaluate the effect of bisphosphonates on dental implant failure rates, marginal bone loss, and postoperative infections.
    • To test the hypothesis of no difference in outcomes between patients receiving and not receiving BPs.

    Main Methods:

    • A systematic electronic search of major databases (PubMed/Medline, Web of Science, Embase) was conducted in October 2015.
    • Inclusion criteria encompassed human clinical studies, both randomized and non-randomized.
    • Meta-analysis was performed on eligible studies to assess various implant outcomes.

    Main Results:

    • Meta-analysis of 18 publications indicated a higher risk ratio (1.73) for implant failure in patients taking bisphosphonates (P = .003).
    • The estimated probability of implant failure for bisphosphonate users was 1.5% (P < .001).
    • Insufficient data precluded definitive conclusions on the effects of BPs on marginal bone loss and postoperative infections.

    Conclusions:

    • Current evidence is insufficient to definitively conclude that bisphosphonates affect dental implant failure rates.
    • Limitations include a low number of studies, low specificity, and lack of proper control groups in many included studies.
    • The precise influence of bisphosphonates on osseointegration and dental implant survival requires further investigation.