Bone antiresorptive or antiangiogenic medication and dental implant treatment in osteoporotic patients : A systematic review

Abstract: Aim: The overall aim is to (i) analyze the prognosis of dental implant treatment concerning marginal bone loss (MBL) in patients undergoing or have undergone treatment with bone antiresorptive or antiangiogenic medication for osteoporosis (ii) and additional purpose to assess the available scientific literature in the first aim concerning the risk of getting medication-related osteonecrosis of the jaw (MRONJ) associated with dental implant installation.  Material and methods: A systematic literature search was conducted in October 2021 in the following three databases; MEDLINE/PubMed, Cochrane Library and Web of Science. PRISMA 2009 Flow Diagram were used for the selection process, whereas the included studies were evaluated for quality assessment using Newcastle Ottawa Scale (NOS).  Results: The search resulted in four included studies considering the eligibility criteria. The studies evaluated MBL in osteoporotic patients undergoing or have undergone oral bisphosphonate (BP) treatment before and/or during implant placement. MRONJ was also assessed in all four articles.  Conclusions: The results of this present study do not indicate that patients undergoing or have undergone antiresorptive or antiangiogenic medication for osteoporosis are at an increased risk of MBL in dental implants during follow-up periods. The present data assessing the risk for developing MRONJ remains low for osteoporotic patients. Therefore, dental implant surgery is considered possible with success in osteoporotic patients receiving earlier mentioned medications. However additional studies are required to evaluate the effects on this patient group concerning osseointegration of dental implant regarding MBL.