Major aspects of the use of bisphosphonates for dental implants in patients with or without osteoporosis:

Abstract

Introduction: In the setting of Medication-Related Osteonecrosis of the Jaw (MRONJ) it was first reported in association with the use of bisphosphonates (BP) by maxillofacial surgeons. The potency and route of administration of BPs are identified as important risk factors. Objective: It was to evaluate the use of bisphosphonates and their side effects in patients with or without osteoporosis, with emphasis on osteonecrosis of the jaws, for dental implants. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October to December 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2005 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly. according to the Cochrane instrument. Results and Conclusion: A total of 120 articles were found, and 55 articles were evaluated in full and 34 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 15 studies with a high risk of bias and 32 studies that did not meet GRADE. For patients with established osteoporosis, there are drugs that, in general, act directly on the bone remodeling process, seeking to reduce bone resorption, including BP, which are drugs of proven efficacy that act in the prevention and treatment of several bone diseases. Osteoporosis is a factor that delays the regeneration of the maxillary bone in patients submitted to implant surgery, prolonging the normal recovery time of the maxillary bone, which can vary from three to six months. Alendronate sodium is used to decrease bone resorption, the drug should be considered an adjuvant therapeutic agent for the treatment of osteoporosis. However, studies have shown that there is a risk of osteonecrosis with the use of bisphosphonates.