Effect of dental implants on bisphosphonate-related osteonecrosis of the jaws

Objective: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate therapy. Dental implants are believed to be a risk factor for developing BRONJ. In the present study we analyze the time span of developing BRONJ in patients treated with bisphosphonate and receiving dental implants. Study design: Patients with dental implants and established BRONJ at the Medical University Clinic of Vienna and studies from 1978 to 2012 were included in a meta-analysis. Three groups were created: a) implantation before bisphosphonate treatment, b) implantation after bisphosphonate treatment, c) implantation during bisphosphonate treatment. Outcomes were evaluated by linear regression analysis. Results: Patients who underwent dental implantation during (p0.001) and after treatment with bisphosphonates developed BRONJ more rapidly (p0.001). The duration of treatment with oral bisphosphonates was significantly related to the rapidity of developing BRONJ (p=0.03). Conclusion: The insertion of dental implants during or after bisphosphonate treatment accelerates the development of BRONJ. BRONJ occurs less frequently during oral bisphosphonate treatment and dental implantation. Keywords: BRONJ, Dental Implants, ONJ, Osteomyelitis, Bisphossphonates