Antiresorptive Therapy to Reduce Fracture Risk and Effects on Dental Implant Outcomes in Patients With Osteoporosis: A Systematic Review and Osteonecrosis of the Jaw Taskforce Consensus Statement

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-05-01 DOI:10.1016/j.eprac.2025.02.016

Dalal S. Ali MD, MSc, FRCPI , Aliya A. Khan MD, FRCPC, FACP, FACE, FASBMR , Archibald Morrison DDS, PhD , Sotirios Tetradis DDS, PhD , Reza D. Mirza MD, MSc, FRCPC , Mohamed El Rabbany DDS, MSc, PhD, FRCDC , Bo Abrahamsen MD, PhD , Tara L. Aghaloo DDS, MD, PhD , Hatim Al-Alwani MD , Rana Al-Dabagh DDS , Athanasios D. Anastasilakis MD , Mohit Bhandari O.Ont, MD, PhD, FRCSC , Jean-Jacques Body MD , Maria Luisa Brandi MD, PhD , Romina Brignardello-Petersen PhD , Jacques P. Brown MD , Angela M. Cheung MD , Juliet Compston MD , Cyrus Cooper MD , Adolfo Diez-Perez MD, PhD , Salvatore L. Ruggiero DMD, MD, FACS

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引用次数: 0

Abstract

Objective

Placement of a dental implant in a patient on antiresorptive therapy has been hypothesized to increase the risk of medication-related osteonecrosis of the jaw (MRONJ) and/or impact implant survival. In patients with osteoporosis, the risk of MRONJ with antiresorptive therapy is only marginally higher than observed in the general population.

Methods

The International ONJ Taskforce conducted a systematic review of the literature and evaluated the outcomes of implant placement in individuals with osteoporosis receiving antiresorptive therapy.

Results

The data were reviewed by the International Taskforce, and consensus was achieved on the following GRADEd recommendation. In patients with osteoporosis on antiresorptive therapy, the Taskforce suggests that antiresorptive therapy does not need to be stopped prior to proceeding with dental implant (weak recommendation, very low-quality evidence). Long-term bisphosphonate use maybe associated with a small increase in the risk of MRONJ (3 cases per 1000 patients; adjusted hazard ratio: 4.09, 95% CI: 2.75-6.09, P < .001, moderate certainty).

Conclusion

Current evidence does not suggest an association between antiresorptive therapy in patients with osteoporosis and dental implant failure. Implants may be safely placed in the presence of concomitant use of bisphosphonates or denosumab in patients with osteoporosis with no evidence of an increased risk of implant failure/compromise.

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抗骨吸收治疗降低骨质疏松患者骨折风险和对种植牙预后的影响：一项系统综述和颌骨骨坏死工作组共识声明

目的：在接受抗吸收治疗的患者中放置牙种植体可能会增加药物相关性颌骨骨坏死（MRONJ）的风险和/或影响种植体的存活。在骨质疏松症患者中，抗吸收治疗的MRONJ风险仅略高于普通人群。方法：国际ONJ工作组对文献进行了系统回顾，并评估了骨质疏松症患者接受抗吸收治疗的种植体放置的结果。结果国际工作组对数据进行了审查，并就以下分级建议达成了共识。对于接受抗骨吸收治疗的骨质疏松症患者，工作组建议在种植牙前不需要停止抗骨吸收治疗（弱推荐，证据质量很低）。长期使用双膦酸盐可能与MRONJ风险的小幅增加有关(每1000例患者中有3例；校正风险比：4.09,95% CI: 2.75-6.09, P <；.001，中等确定性)。结论目前没有证据表明骨质疏松患者的抗吸收治疗与种植体失败之间存在关联。骨质疏松症患者可以在同时使用双膦酸盐或地诺单抗的情况下安全地放置植入物，没有证据表明植入物失败/受损的风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.