Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw With Plasma Rich in Growth Factors After Dental Implant Surgery: A Case Report

2019 ◽  
Vol 45 (4) ◽  
pp. 289-296 ◽  
Author(s):  
Ignacio García Gil ◽  
Barbara Molina Ponte ◽  
Sergio Trapote Mateo ◽  
Jaime Jiménez García
Keyword(s):  
Growth Factors ◽  
Dental Implants ◽  
Dental Implant ◽  
Clinical Case ◽  
Scientific Evidence ◽  
Osteonecrosis Of The Jaw ◽  
Oral Bisphosphonates ◽  
Implant Surgery ◽  
Dental Implant Surgery

Oral bisphosphonates are commonly used to improve bone density in patients who suffer from a variety of pathologies. However, they have also been known to cause bisphosphonate-related osteonecrosis of the jaws (BRONJ). The aim of this clinical case presentation is to (1) determine whether the currently recommended length of time that oral bisphosphonates should be discontinued, before performing dental implant surgery, is sufficient to prevent BRONJ and (2) to describe an alternative treatment for BRONJ. A 65-year-old female patient developed BRONJ after receiving mandibular dental implants 5 months after discontinuing alendronic acid (Fosamax). The BRONJ was treated by surgical osteotomy and plasma rich in growth factors (PRGF), and the patient was followed up with biweekly examinations, which included 0.2% chlorhexidine mouthwashes and removal of any remaining necrotic bone. The dental implants were loaded 41 weeks after surgery and followed up with periapical radiographs and implant stability quotient measurements at 3, 6, 12, and 24 months postloading. Although the Association of Oral and Maxillofacial Surgeons protocols for suspension of presurgical oral bisphosphonates were followed, this patient still developed BRONJ after implant surgery. While a multitude of treatments have been described in the literature, there is not enough scientific evidence to support any one treatment. Based on this clinical case, it can be concluded that the potential adverse effects of oral bisphosphonates on the jaws could be greater than expected and that treatment with PRGF produces promising results, although more long-term studies are necessary to confirm these findings.

Unusual Case of Bevacizumab-Related Osteonecrosis of the Jaw Associated with Dental Implant Surgery

2018 ◽  
Vol 126 (3) ◽  
pp. e50-e51
Author(s):  
Gustavo Maluf Dib Valerio ◽  
Carlos Henrique Dos Anjos ◽  
Eduardo Rodrigues Fregnani ◽  
Paulo Sérgio Silva Santos
Keyword(s):  
Dental Implant ◽  
Unusual Case ◽  
Osteonecrosis Of The Jaw ◽  
Implant Surgery ◽  
Dental Implant Surgery

Flapless Versus Traditional Dental Implant Surgery: Long-Term Evaluation of Crestal Bone Resorption

2016 ◽  
Vol 74 (7) ◽  
pp. 1354-1359 ◽  
Author(s):  
Luca Pisoni ◽  
Paolo Ordesi ◽  
Paolo Siervo ◽  
Andrea Edoardo Bianchi ◽  
Marco Persia ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Dental Implant ◽  
Implant Surgery ◽  
Term Evaluation ◽  
Dental Implant Surgery

scholarly journals Systematic review on diabetes mellitus and dental implants: an update

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Juliane Wagner ◽  
Johannes H. Spille ◽  
Jörg Wiltfang ◽  
Hendrik Naujokat
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Dental Implants ◽  
Dental Implant ◽  
International Diabetes Federation ◽  
Diabetic Patients ◽  
Oral Rehabilitation ◽  
Implant Surgery ◽  
Controlled Conditions ◽  
Dental Implant Surgery

Abstract Purpose Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186–191, 2010), (Khader et al., in J Diabetes Complicat 20:59–68, 2006, 10.1016/j.jdiacomp.2005.05.006)]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success. Methods A systematic literature research based on the PRISMA statement was conducted to answer the PICO question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”. We included 40 clinical studies and 16 publications of aggregated literature in this systematic review. Results We conclude that patients with poorly controlled diabetes mellitus suffer more often from peri-implantitis, especially in the post-implantation time. Moreover, these patients show higher implant loss rates than healthy individuals in long term. Whereas, under controlled conditions success rates are similar. Perioperative anti-infective therapy, such as the supportive administration of antibiotics and chlorhexidine, is the standard nowadays as it seems to improve implant success. Only few studies regarding dental implants in patients with prediabetic conditions are available, indicating a possible negative effect on developing peri-implant diseases but no influence on implant survival. Conclusion Dental implant procedures represent a safe way of oral rehabilitation in patients with prediabetes or diabetes mellitus, as long as appropriate precautions can be adhered to. Accordingly, under controlled conditions there is still no contraindication for dental implant surgery in patients with diabetes mellitus or prediabetic conditions.

scholarly journals Oral Rehabilitation With Dental Implants and the Importance of a Preventive Evaluation for Osteonecrosis of the Jaws Associated With Medications

2020 ◽  
Vol 46 (4) ◽  
pp. 431-437
Author(s):  
Gustavo Zanna Ferreira ◽  
Amanda Bolognesi Bachesk ◽  
Andressa Bolognesi Bachesk ◽  
Gustavo Jacobucci Farah ◽  
Liogi Iwaki Filho ◽  
...  
Keyword(s):  
Dental Implant ◽  
Side Effect ◽  
Clinical Case ◽  
Osteonecrosis Of The Jaw ◽  
Oral Rehabilitation ◽  
Osteonecrosis Of The Jaws ◽  
Systemic Factors ◽  
Oral Complication ◽  
Dental Implant Surgery ◽  
Preventive Methods

Osteonecrosis of the jaw is a possible oral complication resulting from antiresorptive therapies, such as bisphosphonates (Bfs). Although the etiology is not entirely clear, it has been shown to be dependent on several factors, with the traumatic stimulation caused by the placement of teeth implants indicated as one of the predisposing factors to this pathology. The indications and preventive methods for performing these procedures have been questioned, making it essential to determine the proper protocols. Thus, the present study aims to discuss the risks of the development of osteonecrosis in patients undergoing dental implant surgery who use Bfs as well as to discuss related local and systemic factors and possible methods for preventing this side effect. The study also aims to present a clinical case of an osteopenic patient who used Bfs and underwent rehabilitation through implants according to specific protocols, which resulted in successful treatment.

scholarly journals Prescription of Antibiotic Prophylaxis for Dental Implant Surgery in Healthy Patients: A Systematic Review of Survey-Based Studies

2021 ◽  
Vol 11 ◽  
Author(s):  
Juan Carlos Bernabeu-Mira ◽  
Miguel Peñarrocha-Diago ◽  
David Peñarrocha-Oltra
Keyword(s):  
Systematic Review ◽  
Antibiotic Prophylaxis ◽  
Dental Implant ◽  
Response Rate ◽  
Scientific Evidence ◽  
Implant Failure ◽  
Implant Surgery ◽  
Systemic Antibiotic ◽  
Dental Implant Surgery ◽  
Systemic Antibiotic Prophylaxis

Background: Systemic antibiotic prophylaxis is frequently prescribed by dentists performing dental implant surgery to avoid premature implant failure and postoperative infections. The scientific literature suggests that a single preoperative dose suffices to reduce the risk of early dental implant failure in healthy patients.Material and Methods: A systematic review was made based on an electronic literature search in the PubMed-Medline, Embase, Web of Science, Scopus and Open Gray databases. The review addressed the question: “which antibiotic prophylaxis regimens are being used in dental implant surgery in healthy patients according to survey-based studies?” The identification, screening, eligibility and inclusion phases were conducted according to the PRISMA statement by two independent reviewers. The following data were collected: country, number of surveyed dentists, number of dentists who responded (n), response rate, routine prescription of antibiotic prophylactic treatment (yes, no, or conditioned prescription), prescription regimen (preoperative, perioperative or postoperative) and antibiotic choice (first and second choice). Cohen’s kappa coefficient (k) evaluated the level of agreement between the two reviewers. The analysis of risk of bias was performed follow the Joanna Briggs Institute checklist for observational studies. A descriptive statistical analysis was performed to calculate total target sample, sample size and total mean.Results: A total of 159 articles were identified, of which 12 were included in the analysis. Two thousand and seventy-seven dentists from nine different countries on three continents were surveyed. The median response rate was low and disparate between studies. About three-quarters of the surveyed dentists claimed to routinely prescribe systemic antibiotic prophylaxis for dental implant surgery. The prescription regimen was perioperative, postoperative and preoperative, in decreasing order of frequency. The most frequent first choice drug was amoxicillin, with amoxicillin-clavulanic acid as second choice.Conclusions: A majority of dentists from different countries do not prescribe systemic antibiotic prophylaxis for dental implant surgery following the available scientific evidence and could be overprescribing. Efforts are needed by dental educators and professionals to reduce the gap between the use of antibiotic prophylaxis for dental implant surgery as supported by the scientific evidence and what is being done by clinicians in actual practice.

scholarly journals INFLUÊNCIA DO USO DE BISFOSFONATOS EM PACIENTES SUBMETIDOS A IMPLANTES DENTÁRIOS: REVISÃO DA LITERATURA

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Luciano Cincurá Silva Santos ◽  
Renato Piai Pereira ◽  
João Milton Rocha Gusmão ◽  
Onily Duarte Silva de Almeida
Keyword(s):  
Clinical Practice ◽  
Dental Implants ◽  
Dental Implant ◽  
Pathological Condition ◽  
Osteonecrosis Of The Jaw ◽  
Additional Research ◽  
Rehabilitation Intervention ◽  
Stomatognathic System

Dental implants and alternatives for patients requiring restoration of stomatognathic system through the replacement of dental units are an increasingly common practice. Treatment of patients with additional complications to dental implant restorations is a constant challenge, especially the patients described in the literature about the failure involving the use of bisphosphonates based drugs, those being touted as directly responsible for the presence of a pathological condition called bisphosphonate-related osteonecrosis of the jaw. A search through two databases was conducted to clarify doubts about the actual influence of factors presented and its true relevance to clinical practice, promoting the knowledge and more consistent strategies in cases requiring rehabilitation intervention. The results show the need for additional research on these topics.

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