There is no agreement of data in the subject of implant failure and the development of osteonecrosis in patients receiving antiresorptive agents. The purpose of this systematic review is to evaluate whether dental implants placed in patients on antiresorptive medication have an increased failure rate and whether the implant placement or the implant existence are risk factors for developing medication-related osteonecrosis of the jaw (MRONJ). An electronic search was conducted in PubMed/Medline and all publications fulfilling the inclusion criteria were included. The search was completed by a hand research of the references cited in all electronic identified publications and resulted in 411 articles. According to the inclusion criteria, 32 studies were included with a total of 5221 patients, 12 751 implants, 618 cases of implants loss and 136 cases of MRONJ analyzed. It cannot be established that antiresorptive medication affects the dental implant survival rates, because of small number of studies, most of them characterized by a low level of quality. The risk of MRONJ as an early or late complication is also not well established. Therefore, successful dental implant procedures on patients receiving antiresorptive medication might be possible, but more studies need to be carried out in the future to verify this topic. Apart from intravenous antiresorptive drugs, which remain an absolute contraindication, dental implantology in patients under antiresorptive medication is not a contraindication but it must be accompanied with a careful treatment planning, patients must be informed about the possible complications and large follow up periods are essential.
The risk of osteonecrosis of the jaw (ONJ) and adverse outcomes in patients using antiresorptive drugs undergoing orthodontic treatment, A protocol for a systematic review
