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Successful Dental Implants for Patients Taking Biphosphonates

Reducing a patient’s treatment time and simplifying the treatment can increase patient acceptance and reduce the risk of complications. For dental implants, this means moving away from the traditional 2stage surgical approach and toward a onestage procedure. The success of this concept, when combined with another complication—that of patients receiving drug therapy for osteoporosis—was studied to determine the best method of treatment in this situation. Osteoporosis is a wellknown disease that weakens bone and increases the risk of fracture, particularly among postmenopausal women. Biphosphonates, an inhibitor of bone resorption, are widely used as a drug therapy for those with osteoporosis. Prolonged used of biphosphonates, however, can lead to a painful refractory bone exposure in the jaws, known as “biphosphonateinduced osteonecrosis of the jaw” (BONJ). This condition usually develops after dental treatment, indicating that oral surgery and implants placed into the jawbone can precipitate BONJ. Although the process is not fully understood, it appears that prolonged use of biphosphonates may suppress the bone’s repair function, interfering with healing after implants.
A study published in the Journal of Oral Implantology involved a total of 54 implants installed in 9 osteoporotic patients, 8 of them female, who ranged from ages 45 to 68 years. All had been taking oral biphosphonates for less than 3 years; a significant increase in risk of developing BONJ is associated with more than 3 years of biphosphonate therapy. Immediate occlusal loading procedures were used, which require that motion at the boneimplant interface be kept below a certain threshold during healing. This study demonstrated a 100% success rate, with all patients rehabilitated with a fullarch prosthesis supported by 6 dental implants. Two years of followup found no adverse events of infection, tissue swelling, or lesions, showing this to be a viable onestage treatment.
(Source: Journal of Oral Implantology, 2012, Volume 38, Number 1; news release March 8, 2012)

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