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.