Title : Impact of anti-resorptive therapy on oral rehabilitation with dental implants
Abstract:
Anti-resorptive therapy includes five pharmacological classes – bisphosphonates, denosumab, hormonal replacement therapy, selective estrogen receptor modulators and calcitonin. It is used to treat pathologies such as osteoporosis, cancer and bone metastases, Paget's disease and osteogenesis imperfecta. Dental implants are considered the best treatment option for replacing missing teeth, having high success rates and numerous advantages over other well-known prosthetic alternatives. Since anti-resorptive therapy interferes with bone metabolism, and implant success depends on the osseointegration process, which in turn depends on bone turnover, it can be assumed that these drugs influence implant success rates. Thus, the main aim of this presentation is to discuss and share information about the impact that anti-resorptive therapy can have on oral rehabilitation with dental implants, namely on survival rates, marginal bone loss and development of medication-related osteonecrosis of the jaws. This pathology appears as a rare complication associated with the use of bisphosphonates and denosumab, being one of the main causes of implant loss. Oral doses of bisphosphonates do not seem to be responsible for the increase in the implant failure rates, nor do they provide differences in the level of osseointegration and marginal bone loss, presenting high success and survival rates. In contrast, intravenous doses of bisphosphonates are associated with bigger failure rates. Besides the impact of this type of drug, the effect of the pharmacological classes previously named will also be debated.The articles about this theme reveal the lack of available evidence on this topic, especially in relation to hormonal replacement therapy, selective estrogen receptor modulators and calcitonin, demonstrating the urgent need for further studies as well as the need to create universal medical practice guidelines.
