Major considerations of the use of bisphosphonate in implantology: a systematic review

Introduction: It is estimated that the number of dental implants used in the United States increased more than 10 times between 1983 and 2002 and another five times between 2000 and 2005. More than one million dental implants are performed each year. In this sense, one of the main causes of osteopenia in women over 60 years of age is an estrogen deficiency. Thus, bisphosphonates has been the best drug associated with a significant improvement in the quality of life of patients with bone diseases, such as Paget's disease, bone metastases, imperfect osteogenesis, hypercalcemia, and even severe osteoporosis. Objective: to review, through a systematic literature review, the use of bisphosphonate-associated with dentistry. Methods: Experimental and clinical studies were included (case reports, retrospective, prospective and randomized studies) with qualitative and/or quantitative analysis. For greater specifications, the description “bone necrosis” for refinement was added during the research, following the rules of systematic review-PRISMA. 155 articles were found involving implantology and biomaterial. A total of 45 articles were evaluated in full and 37 were included and discussed in this study. Major findings: Bisphosphonate coating of dental implants is a promising tool for surface modification, with the aim of improving the osseointegration process and the clinical outcome. The biological effects of bisphosphonates arethought to be mainly associated with the inhibition of osteoclasts, while their effects on osteoblast function are unclear. Thus, surfaces coated with bisphosphonates to stimulate osteoblast differentiation have been investigated by several in vitro studies with contradictory results. Conclusion: Osteoporosis is a metabolic condition that affects alveolar bone density, but does not present problems for the installation of osseointegrated implants, as long as there is sufficient bone mass in the region where the tooth will be implanted. Alendronate sodium is used to decrease bone resorption and should be considered as an adjunct therapeutic agent for the treatment of osteoporosis.