Tsolaki Ioanna N, Madianos Phoebus N, Vrotsos John A
Private Practice, Athens, Greece.
J Prosthodont. 2009 Jun;18(4):309-23. doi: 10.1111/j.1532-849X.2008.00433.x. Epub 2009 Feb 2.
This article reviews available data on the outcome of dental implants in osteoporotic patients.
A search was performed in PubMed and completed in July 2007. The keywords "dental AND implants AND osteoporosis," "dental AND implants AND age," "dental AND implants AND gender," and "dental AND implants AND bone AND quality," with no limitations for language or year of publication, resulted in 82, 598, 94, and 541 articles, respectively. After abstract scanning (in case of doubt the article was read), 39 nonreview articles studying dental implant outcomes in osteoporotic/osteopenic subjects remained for our review. The bibliographies of the 39 articles were also inspected, but no additional studies were identified.
Thirteen of 16 animal studies found lower osseointegration rates in osteoporotic/osteopenic bone than in normal bone. Six in nine clinical reports mention success. Eight of 12 studies in humans support the applicability of dental implants in osteoporotic patients.
There are no data to contraindicate the use of dental implants in osteoporotic patients; however, a proper adjustment of the surgical technique and a longer healing period may be considered in order to achieve osseointegration. Data on the use of biphosphonates in osteoporotic patients and implant outcomes are very limited, and no conclusions can be drawn. In addition, large prospective studies investigating the long-term success of dental implants in osteoporotic individuals are required.
本文综述了骨质疏松患者牙种植体治疗效果的现有数据。
于2007年7月在PubMed数据库进行检索。关键词“牙与种植体与骨质疏松症”“牙与种植体与年龄”“牙与种植体与性别”以及“牙与种植体与骨与质量”,对语言和发表年份无限制,分别检索到82、598、94和541篇文章。经摘要筛选(如有疑问则阅读全文),最终纳入39篇非综述类文章用于评估骨质疏松/骨量减少患者的牙种植体治疗效果。同时也查阅了这39篇文章的参考文献,但未发现其他相关研究。
16项动物研究中有13项发现骨质疏松/骨量减少骨中的骨结合率低于正常骨。9项临床报告中有6项提及了成功案例。12项人体研究中有8项支持牙种植体在骨质疏松患者中的应用。
目前尚无数据表明骨质疏松患者禁忌使用牙种植体;然而,为实现骨结合,可考虑适当调整手术技术并延长愈合时间。关于骨质疏松患者使用双膦酸盐与种植体治疗效果的数据非常有限,无法得出结论。此外,需要开展大型前瞻性研究以调查牙种植体在骨质疏松个体中的长期成功率。