Title |
Impact Of Bisphosphonates On Implant Failure Is Unclear |
Clinical Question |
Do bisphosphonstes prescribed for osteoporosis increase the likelihood of implant failure in older adults? |
Clinical Bottom Line |
Based on a literature review of case reports and retrospective studies, there is no definitive risk of implant failure in bisphosphonate users, though several studies suggest there may be. Given lack of RCTs and heterogeneity among retrospective studies, further investigation is required. |
Best Evidence |
|
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
20594057 | Zahid / 2011 | 362 consecutive human adults | Retrospective Chart Review | Key results | There was no difference in implant failure between patients treated with bisphosphonates and those that were not (OR 2.32 (0.64-8.36)). However, there was more thread exposure in the bisphosphonate treated group (OR 3.25 (1.58-6.72)). The patients were taking bisphosphonates for osteoporosis. | 20367090 | Javed / 2010 | 287 human adults | Literature Review of retrospective trials and case reports. | Key results | No difference was reported on implant viability as this was a literature review. Only reported that studies had mixed results and the impact on implant survival between patients being treated with bisphosphonates was unclear. No p values or CI were reported given lack of statistical analysis. | |
Evidence Search |
Bisphosphonates AND Dental Implant Failure |
Comments on
The Evidence |
These studies were heterogeneous with respect to patient population, and neither study investigated dissimilarities between treatment and control groups. Nevertheless, there was sufficient followup as well as exposure prior to onset of outcome. |
Applicability |
These results are applicable to adult patients with osteoporosis taking bisphosphonates who are considering implant therapy. |
Specialty |
(General Dentistry) (Periodontics) (Prosthodontics) |
Keywords |
Bisphosphonates, Dental Implants, Implant Failure
|
ID# |
2103 |
Date of submission |
09/16/2011 |
E-mail |
MaldonadoAlf@livemail.uthscsa.edu |
Author |
Katherine Maldonado Alfandari |
Co-author(s) |
|
Co-author(s) e-mail |
|
Faculty mentor |
Yong-Hee Patricia Chun, DDS, MS, PhD |
Faculty mentor e-mail |
ChunY@uthscsa.edu |
|
|
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
by Hohyun Ryan Ryou, Matthew Gesell (San Antonio, TX) on 12/08/2017 A PubMed search conducted in November 2017 found a limited amount of related evidence that does not change the conclusion of the CAT. At about the same time the CAT was written, a systematic review (Madrid, 2009, PMID 19663954) and a retrospective study (Shabestari, 2010, PMID 19438964) were published. New research has been done since then in the forms of retrospective study (Al-Sabbagh, 2015, PMID 25764480), case control study (Famili, 2015, PMID 24945991) and meta-analysis (Chen, 2013, PMID 23940794). As mentioned in the CAT, the general consensus amongst the studies is that further research will need to be performed. Only a few thousand implants have been evaluated, which limits the validity and clinical applicability of the research already done. | |