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Quintessence Publishing: Journals: QI
Quintessence International

Edited by Eli Eliav

ISSN 0033-6572 (print) • ISSN 1936-7163 (online)

April 2016
Volume 47 , Issue 4

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Bisphosphonates and dental implants: A meta-analysis

Bruno Ramos Chrcanovic, DDS, MSc / Tomas Albrektsson, MD, PhD / Ann Wennerberg, DDS, PhD

Pages: 329–342
PMID: 26824084
DOI: 10.3290/j.qi.a35523

Objective: To test the null hypothesis of no difference in the implant failure rates, marginal bone loss, and postoperative infection for patients receiving or not receiving bisphosphonates, against the alternative hypothesis of a difference. Method and Materials: An electronic search was undertaken in October 2015 in PubMed/Medline, Web of Science, and Embase, plus hand-searching and databases of clinical trials. Eligibility criteria included clinical human studies, either randomized or not. Results: A total of 18 publications were included in the review. Concerning implant failure, the meta-analysis found a risk ratio of 1.73 (95% confidence interval [CI] 1.21–2.48, P = .003) for patients taking bisphosphonates, when compared to patients not taking the medicament. The probability of an implant failure in patients taking bisphosphonates was estimated to be 1.5% (0.015, 95% CI 0.006– 0.023, standard error [SE] 0.004, P < .001). It cannot be suggested that bisphosphonates may affect the marginal bone loss of dental implants, due to a limited number of studies reporting this outcome. Due to a lack of sufficient information, meta-analysis for the outcome “postoperative infection” was not performed. Conclusion: The results of the present study cannot suggest that the insertion of dental implants in patients taking BPs affects the implant failure rates, due to a limited number of published studies, all characterized by a low level of specificity, and most of them dealing with a limited number of cases without a proper control group. Therefore, the real effect of BPs on the osseointegration and survival of dental implants is still not well established.

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