Does local delivery of bisphosphonates influence the osseointegration of titanium implants? A systematic review

The aim of this study was to systematically review the influence of the local delivery of bisphosphonates on the osseointegration of titanium implants in humans. A search of health sciences databases was performed (The Cochrane Library, Embase, PubMed MEDLINE, ISI Web of Knowledge, Scopus, and SIGLE OpenGrey), including articles published until October 2016. A total of 679 articles were identified. Following the removal of duplicates, 278 were screened by title and abstract. The complete texts of seven studies were read, and of these, three met the inclusion criteria. Each article included in the analysis was submitted to a quality and level of evidence evaluation, and relevant data were extracted and tabulated. Despite methodological differences, all articles presented positive results for osseointegration when a local bisphosphonate was used: the authors reported greater implant stability, better implant survival rates, and reduced peri-implant bone loss when compared with the control groups. On the basis of the results of this systematic review, it is concluded that the local use of a bisphosphonate appears to favour the osseointegration of titanium implants in humans. Nonetheless, a higher level of standardization and the control of methodological bias is required in future research so that stronger evidence might be produced.