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Marginal Bone Loss Around Dental Implants and Its Association with Chronic Corticosteroid Use: A Prospective Cohort
Reza Tabrizi1, Hediyeh Koohi2, Shima Moradian-Lotfi2
1School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background:
Prolonged corticosteroid use leads to glucocorticoid-induced osteoporosis.
Objective:
This study aimed to assess marginal bone loss around dental implants in patients with chronic corticosteroid use.
Methodology:
This prospective cohort study included patients who required dental implant therapy on the posterior maxilla and mandible with a history of chronic corticosteroid use (12 months or longer). A control group was considered without corticosteroids to compare marginal bone loss (MBL). The implants were loaded with cemented restorative crowns 4 months after placement. Radiographs were obtained immediately after loading and 12 months later. The vertical distance between the shoulder of the implant and the highest point of the surrounding alveolar bone was defined as the initial marginal bone surface. The use of chronic corticosteroids (12 months or more) is the primary predictive factor. Marginal bone loss (MBL) was the study's primary outcome, defined as the difference between the reference point and the new marginal bone level after 12 months. The study covariates included age, gender, implant sites, corticosteroid dose, and gingival type (thick or thin).
Results:
In total, 154 subjects (75 cases and 79 controls) were included in our study. The mean age was 45.33 ± 10.44 and 43.37 ± 10.07 among the cases and controls, respectively (p-value = 0.237), and the mean corticosteroid dosage was 6.43 ± 2.50. Among the cases, 68% (n = 51) had bone type III, and 32% (n = 24) had bone type IV. Among the control group, 40.50% (n = 32), 58.22% (n = 46), and 1.26% (n = 1) had bone types IV, III, and II, respectively. We found a significant correlation between MBL and corticosteroid use in both the mandible (Pearson's correlation = 0.921, p-value < 0.001) and maxilla (Pearson's correlation = 0.871, p-value < 0.001).
Conclusion:
The study results revealed a dose-response relationship between marginal bone loss and corticosteroid use, suggesting that prolonged corticosteroid use increases the risk of implant failure.
