Implant treatment in patients with osteoporosis

ABSTRACT

Osteoporosis is very common, particularly in post-menopausal women and is characterized by a decrease in bonemass and strength. Osteoporosis also affects the jawbone and it is considered a potential contraindication to placementof dental implants. The present paper reviews the literature regarding the effect of osteoporosis on osseointegrationof implants. Experimental models have shown that osteoporosis affects the process of osseointegration,which can be reversed by treatment. However, studies in subjects with osteoporosis have shown no differencesin survival of the implants compared to healthy individuals. Therefore, osteoporosis cannot be considered a contraindicationfor implant placement. Oral bisphosphonates are the most commonly used pharmacological agents inthe treatment of osteoporosis. Although there have been cases of osteonecrosis of the jaw in patients treated withbisphosphonates, they are very rare and it is more usually associated with intravenous bisphosphonates in patientswith neoplasms or other serious diseases. Nevertheless, patients treated with bisphosphonates must be informed inwriting about the possibility of this complication and must give informed consent. Ceasing to use bisphosphonatesbefore implant placement does not seem to be necessary (AU)

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