Bisphosphonates and Their Influence on the Implant Failure: A Systematic Review
Bibliographic record
Abstract
Objective: The goal of this systematic review was to study the relationship between the use of bisphosphonates (oral or intravenous) and its effect on implant osseointegration. Methods: The focused question was “In patients medicated with bisphosphonates and who underwent surgery to place dental implants, what is the influence of that medication (of different generations) on the failure of dental implants (O)?” Following specific eligibility criteria, four databases (PubMed/MEDLINE, Scopus, Web of Science, DOAJ) were electronically screened to search the articles. Specific MeSH terms were used in combinations with Boolean Operators “AND” and “OR” for the research. In addition, a manual search was done. The data extracted were the (i) author, (ii) year of publication, (iii) country, (iv) research question, (v) study design, (vi) patient information, (vii) the number of patients included, (viii) patient/implant status, (ix) the number of implants evaluated, (x) type of implant, (xi) risk factors, and (xii) findings obtained. Moreover, the following were also registered: the (i) type, generation, duration, and route for BP administrated; (ii) the presence of any systemic condition and drug treatment; (iii) follow-up (months); and (iv) implant failure rate (%). The quality assessment of the included studies was carried out using the Modified Newcastle–Ottawa scale. Results: A total of 491 articles were found (183 in PubMed/MEDLINE, 171 in Scopus, 65 in Web of Science, and 72 articles in DOAJ), and 17 articles were considered for full-text reading. After the exclusion of 3 articles, 14 were included in this systematic review (11 case reports, 2 retrospective, and 1 prospective study). The reasons for the bisphosphonates intaking included osteoporosis, multiple myeloma, breast cancer, knee cancer, and osteogenesis imperfecta. The oral administration involved Alendronato (eight studies), Risedronate (three studies), and Ibandronate (three studies); whereas the intravenous administrations were Zoledronate (seven studies), Clodronato (one study), and Pamidronato (three studies). The duration of use of bisphosphonates at the time of implant placement was diverse; it ranged from no interruption of bisphosphonate intaking up to its discontinuation for 2, 3, or 6 months before surgery, with respective use being resumed 1, 3, or 8 months after surgery. Antibiotic treatment (amoxicillin + clavulanic acid) was performed before the intervention in two cases and after the intervention in three cases. Finally, the percent of implant failure rate when intaking BPs had an average of 49.96%. Conclusions: Within the limitation of this systematic review, it was possible to conclude that a high mean failure rate of implant osseointegration (49.96%) was found, regardless of the generation of bisphosphonates used. Moreover, the failure rate was lower in patients using second generation bisphosphonates (Alendronate and Pamidronate) and was higher with the IV administration compared to the oral administration of bisphosphonates.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".