Dental implants in patients treated with antiresorptive medication – a systematic literature review
Identifieur interne : 000919 ( Main/Exploration ); précédent : 000918; suivant : 000920Dental implants in patients treated with antiresorptive medication – a systematic literature review
Auteurs : Christian Walter [Allemagne] ; Bilal Al-Nawas [Allemagne] ; Tim Wolff [Allemagne] ; Eik Schiegnitz [Allemagne] ; Knut A. Grötz [Allemagne]Source :
- International Journal of Implant Dentistry [ 2198-4034 ] ; 2016.
Abstract
Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.
The PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.
There is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.
Successful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.
Url:
DOI: 10.1186/s40729-016-0041-7
PubMed: 27747701
PubMed Central: 5005701
Affiliations:
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Grötz</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199 Wiesbaden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199 Wiesbaden</wicri:regionArea><wicri:noRegion>65199 Wiesbaden</wicri:noRegion><wicri:noRegion>65199 Wiesbaden</wicri:noRegion><wicri:noRegion>65199 Wiesbaden</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27747701</idno><idno type="pmc">5005701</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5005701</idno><idno type="RBID">PMC:5005701</idno><idno type="doi">10.1186/s40729-016-0041-7</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000E41</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000E41</idno><idno type="wicri:Area/Pmc/Curation">000E41</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000E41</idno><idno type="wicri:Area/Pmc/Checkpoint">000774</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000774</idno><idno type="wicri:Area/Ncbi/Merge">006B41</idno><idno type="wicri:Area/Ncbi/Curation">006B41</idno><idno type="wicri:Area/Ncbi/Checkpoint">006B41</idno><idno type="wicri:Area/Main/Merge">000919</idno><idno type="wicri:Area/Main/Curation">000919</idno><idno type="wicri:Area/Main/Exploration">000919</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Dental implants in patients treated with antiresorptive medication – a systematic literature review</title><author><name sortKey="Walter, Christian" sort="Walter, Christian" uniqKey="Walter C" first="Christian" last="Walter">Christian Walter</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz</wicri:regionArea><wicri:noRegion>55131 Mainz</wicri:noRegion><wicri:noRegion>55131 Mainz</wicri:noRegion><wicri:noRegion>55131 Mainz</wicri:noRegion></affiliation></author><author><name sortKey="Al Nawas, Bilal" sort="Al Nawas, Bilal" uniqKey="Al Nawas B" first="Bilal" last="Al-Nawas">Bilal Al-Nawas</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz</wicri:regionArea><wicri:noRegion>55131 Mainz</wicri:noRegion><wicri:noRegion>55131 Mainz</wicri:noRegion><wicri:noRegion>55131 Mainz</wicri:noRegion></affiliation></author><author><name sortKey="Wolff, Tim" sort="Wolff, Tim" uniqKey="Wolff T" first="Tim" last="Wolff">Tim Wolff</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199 Wiesbaden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199 Wiesbaden</wicri:regionArea><wicri:noRegion>65199 Wiesbaden</wicri:noRegion><wicri:noRegion>65199 Wiesbaden</wicri:noRegion><wicri:noRegion>65199 Wiesbaden</wicri:noRegion></affiliation></author><author><name sortKey="Schiegnitz, Eik" sort="Schiegnitz, Eik" uniqKey="Schiegnitz E" first="Eik" last="Schiegnitz">Eik Schiegnitz</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz</wicri:regionArea><wicri:noRegion>55131 Mainz</wicri:noRegion><wicri:noRegion>55131 Mainz</wicri:noRegion><wicri:noRegion>55131 Mainz</wicri:noRegion></affiliation></author><author><name sortKey="Grotz, Knut A" sort="Grotz, Knut A" uniqKey="Grotz K" first="Knut A." last="Grötz">Knut A. Grötz</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199 Wiesbaden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199 Wiesbaden</wicri:regionArea><wicri:noRegion>65199 Wiesbaden</wicri:noRegion><wicri:noRegion>65199 Wiesbaden</wicri:noRegion><wicri:noRegion>65199 Wiesbaden</wicri:noRegion></affiliation></author></analytic><series><title level="j">International Journal of Implant Dentistry</title><idno type="eISSN">2198-4034</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.</p></sec><sec><title>Methods</title><p>The PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.</p></sec><sec><title>Results</title><p>There is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.</p></sec><sec><title>Conclusion</title><p>Successful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Grotz, Ka" uniqKey="Grotz K">KA Grötz</name></author><author><name sortKey="Piesold, Ju" uniqKey="Piesold J">JU Piesold</name></author><author><name sortKey="Al Nawas, B" uniqKey="Al Nawas B">B Al-Nawas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Walter, C" uniqKey="Walter C">C Walter</name></author><author><name sortKey="Al Nawas, B" uniqKey="Al Nawas B">B Al-Nawas</name></author><author><name sortKey="Frickhofen, N" uniqKey="Frickhofen N">N Frickhofen</name></author><author><name sortKey="Gamm, H" uniqKey="Gamm H">H Gamm</name></author><author><name sortKey="Beck, J" uniqKey="Beck J">J Beck</name></author><author><name sortKey="Reinsch, L" uniqKey="Reinsch L">L 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uniqKey="Cho S">SC Cho</name></author><author><name sortKey="Francisco, H" uniqKey="Francisco H">H Francisco</name></author><author><name sortKey="Tarnow, Dp" uniqKey="Tarnow D">DP Tarnow</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lopez Jornet, P" uniqKey="Lopez Jornet P">P Lopez-Jornet</name></author><author><name sortKey="Camacho Alonso, F" uniqKey="Camacho Alonso F">F Camacho-Alonso</name></author><author><name sortKey="Martinez Canovas, A" uniqKey="Martinez Canovas A">A Martinez-Canovas</name></author><author><name sortKey="Molina Minano, F" uniqKey="Molina Minano F">F Molina-Minano</name></author><author><name sortKey="Gomez Garcia, F" uniqKey="Gomez Garcia F">F Gomez-Garcia</name></author><author><name sortKey="Vicente Ortega, V" uniqKey="Vicente Ortega V">V Vicente-Ortega</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li></country></list><tree><country name="Allemagne"><noRegion><name sortKey="Walter, Christian" sort="Walter, Christian" uniqKey="Walter C" first="Christian" last="Walter">Christian Walter</name></noRegion><name sortKey="Al Nawas, Bilal" sort="Al Nawas, Bilal" uniqKey="Al Nawas B" first="Bilal" last="Al-Nawas">Bilal Al-Nawas</name><name sortKey="Grotz, Knut A" sort="Grotz, Knut A" uniqKey="Grotz K" first="Knut A." last="Grötz">Knut A. Grötz</name><name sortKey="Schiegnitz, Eik" sort="Schiegnitz, Eik" uniqKey="Schiegnitz E" first="Eik" last="Schiegnitz">Eik Schiegnitz</name><name sortKey="Wolff, Tim" sort="Wolff, Tim" uniqKey="Wolff T" first="Tim" last="Wolff">Tim Wolff</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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