Evaluation of Effect of Bisphosphonates on Dental Implant Therapy in Postmenopausal Women Using Cone Beam Computed Tomography

Osteoporosis is one of the diseases which show significant bone mass reduction especially in post menopausal women. The present study was conducted to determine the effect of Bisphosphonates (BP) on alveolar bone and dental implant therapy in women after menopause.

The present study was conducted on 30 postmenopausal women who received at least one dental implant in the last 5 years. Group I comprised of 15 patients who were on BP therapy for 1.5 years, and group II consisted of 15 patients who were on parathyroid hormone (PTH). Bone mineral density (BMD) and bone thickness were assessed in both groups.

Group I had 3.85% and group II had 3.15% of dental implants failures. BMD of cortical bone was 1552± 145 mg/mL and 1012 ± 94 mg/mL in groups I and II respectively. BMD of cancellous bone was 80 ± 15 mg/mL and 104 ± 72 mg/mL in group I and group II respectively. The difference was significant (p < 0.05). Cortical bone thickness was 2.5 ± 0.6 mm in group I and 2.2 ± 0.8 mm in group II. The difference was non-significant (p >0.05). There was a reduction in BMD (mg/mL) of cortical and cancellous bone. There was an increase in cortical bone thickness with the use of BPs over the years. The difference was significant (p < 0.05).

There was a decrease in bone mineral density of both cortical and cancellous bone in both groups. There was increase cortical bone thickness on prolonging use of BPs.

Patients on BPs therapy should be carefully evaluated both clinically and radiographically before dental implant treatment as these agents affect the quantity and quality of cortical bone especially in the posterior mandibular region in patients with osteoporosis.