Osseointegration of Dental Implants and Osteoporosis

Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and susceptibility to fractures. Osteoporosis also results in loss of bone mineral density throughout the body, including the maxilla and mandible. Successful osseointegration of dental implants is attributed to their ability to integrate well with bone. The influence of bone quality on dental implant osseointegration has been discussed in several studies, and higher rates of dental implant failure have been reported in patients with low bone quality and an inadequate bone volume. Osteoporosis represents a risk factor for osseointegration, and this relationship may be derived from the association of the disease with a deficiency in bone formation. This condition would compromise the healing capacity and the apposition of bone at the implant interface. Currently, there is no clear consensus regarding dental implant treatment in osteoporotic individuals. Studies have revealed contradictory reports regarding the success and failure of dental implants in patients with osteoporosis. Antiresorptive agents have been widely used to treat osteoporosis. Dental implant placement in patients on bisphosphonate therapy may trigger osteonecrosis of the bone. Hence, it is important to analyze factors that have to be taken into consideration prior to implant therapy in patients with osteoporosis and those undergoing treatment. This chapter outlines dental implant osseointegration under osteoporotic conditions. The possible effect of bisphosphonate therapy on dental implant survival will also be discussed based on the current literature.