THE USE OF DENTAL IMPLANTS IN PATIENTS ON BISPHOSPHONATE THERAPY: A REVIEW OF THE LITERATURE

Bisphosphonate related osteonecrosis of the jaws, which was first described in 2003, shows similarities with an industrial disease commonly known as ‘‘phossy jaw’’ which is characterized with necrotic bony areas located in the jaws of the workers producing white phosphorus based matches, about a hundred years ago. in the 19th century, bisphosphonates were used as anticorrosive agents in the textile and industry. bisphosphonates were initially introduced to the medical usage for more than forty years ago. the main mechanism of action of bisphosphonates is to inhibit bone resorption and consequently, the bone turn-over. bisphosphonates are either orally or intravenously administered. oral bisphosphonates are primarily used for the treatment of osteoporosis as well as the paget’s disease and osteogenesis imperfecta. intravenous bisphosphonates, by being more potent, are commonly prescribed for the prevention and the treatment of bone metastases of osteolytic tumours, hypercalcemia of malignancy, and in the prevention and the treatment of the bone related complications of multiple myeloma. as a side effect, especially intravenous bisphosphonates may cause osteonecrosis of the jaws. clinically, this situation is characterized with exposed necrotic bone located in the mandible or in the maxilla, persisting more than 8 weeks, in patients which are/were on bisphosphonate therapy, without a history of radiotherapy or corticosteroid usage. one of the common oral surgical procedures is the use of dental implants. the number of studies which evaluate the use of dental implants in patients who are/were on bisphosphonate therapy, is scarce. the purpose of this article, is to evaluate the predictibility and the success rate of the dental implants in patients who are/were on bisphosphonate therapy, regarding the literature. the risk of osteonecrosis occurence after implant placement, was also emphasized. the case reports and the clinical studies written in english and were published in medline- on pubmed in between the time period of 1995 january- 2011 april, were reviewed.