Department of Oral and Maxillofacial Surgery, National and Kapodistrian University of Athens, Athens, Greece.
J Oral Implantol. 2021 Apr 1;47(2):169-180. doi: 10.1563/aaid-joi-D-19-00088.
There is no agreement of data on the subject of implant failure and the development of osteonecrosis in patients receiving antiresorptive agents. The purpose of this systematic review is to evaluate whether dental implants placed in patients on antiresorptive medication have an increased failure rate and whether the implant placement or the implant existence are risk factors for developing medication-related osteonecrosis of the jaw (MRONJ). An electronic search was conducted in PubMed/Medline, and all publications fulfilling the inclusion criteria were included. The search was completed by a hand research of the references cited in all electronic identified publications, resulting in 411 articles. Based on the inclusion criteria, 32 studies were included, with a total of 5221 patients, 12 751 implants, 618 cases of implants loss, and 136 cases of MRONJ analyzed. Because of the small number of studies, most of which were characterized by a low level of quality, it cannot be established that the use of antiresorptive medication affects dental implant survival rates. The risk of MRONJ as an early or late complication is also not well established. Therefore, successful dental implant procedures in patients receiving antiresorptive medication might be possible, but more studies need to be carried out in the future to verify this topic. Apart from intravenous antiresorptive drugs, which remain an absolute contraindication, the use of antiresorptive medication is not a contraindication to dental implantology, but it must be accompanied by careful treatment planning, informing patients about possible complications, and essential long follow-up periods.
关于接受抗吸收药物的患者的植入物失败和骨坏死发展问题，目前尚无数据共识。本系统评价的目的是评估接受抗吸收药物治疗的患者中放置的牙科植入物是否失败率更高，以及植入物的放置或存在是否是发生药物相关性颌骨坏死（MRONJ）的危险因素。在 PubMed/Medline 上进行了电子搜索，并纳入了符合纳入标准的所有出版物。通过对所有电子确定出版物中引用的参考文献进行手动研究，完成了搜索，共产生了 411 篇文章。根据纳入标准，共纳入了 32 项研究，共有 5221 名患者、12751 个植入物、618 例植入物丢失和 136 例 MRONJ 进行了分析。由于研究数量较少，且大多数研究质量较低，因此无法确定抗吸收药物的使用会影响牙科植入物的存活率。MRONJ 作为早期或晚期并发症的风险也尚未得到很好的确定。因此，在接受抗吸收药物治疗的患者中成功进行牙科植入手术是可能的，但未来需要进行更多的研究来验证这一主题。除了静脉内抗吸收药物仍然是绝对禁忌证外，抗吸收药物的使用不是牙科植入术的禁忌证，但必须伴随精心的治疗计划、告知患者可能的并发症以及必要的长期随访期。
