Bone Density Around Endosseous Implants in Patients Taking Alendronate: A Pilot Study

The purpose of this blind, randomized, controlled pilot investigation was to noninvasively determine bone mineral density (BMD) changes around endosseous implants placed in healthy patients who were administered the oral aminobisphosphonate alendronate. BMD was analyzed using computed tomography (CT) and grayscale imaging. Male patients (62 ± 12 years of age) were selected for placement of implants in a two-stage protocol. Patients requiring implants were initially seen for placement of half the total number of implants unilaterally in the maxilla or mandible, and each patient underwent a baseline CT scan. Six months from baseline, contralateral implants were placed with randomization into groups receiving 70 mg of alendronate weekly or a placebo, and a second CT scan was completed. Alendronate/placebo was discontinued after 6 months, and a CT scan was completed at 12 months. Patients returned for an exit evaluation and CT scan at 18 months. Hounsfield units were measured at implant placement and nonsurgical sites in the maxilla and mandible. Within the limitations of this study, results included: a decreasing trend in BMD surrounding an implant when alendronate was administered for 6 months starting at the time of implant placement, a less evident decreasing trend in BMD surrounding an implant when alendronate was administered for 6 months after the implant had successfully undergone osseointegration, and a trend suggesting BMD "rebound" when alendronate was discontinued for 6 months after initial drug administration starting either at the time of implant placement or after the implant had successfully undergone osseointegration for 6 months.