Assessment of Role of Bisphosphonates on Dental Implant Treatment in Post-menopausal Ladies

ABSTRACT

Objectives:

To examine the impact of bisphosphonates (BPs) on dental implant treatment and alveolar bone in post-menopausal ladies

Materials and Methods:

Twenty post-menopausal ladies who had at least one dental implant within the previous 5 years participated in the current study. Ten subjects were categorized into two groups: Group A had BP medication for 1.5 years, and group B received parathyroid hormone (PTH). Both groups’ bone thickness and bone mineral density (BMD) were measured.

Result:

Group A had 5%, and group B had 5% of dental implants failures. BMD of cortical bone was 1468 ± 136 mg/mL and 1008 ± 84 mg/mL in groups A and B, correspondingly. The cortical and cancellous bone densities in both the groups were statically significant. Cortical bone thickness was insignificant in comparison

Conclusion:

Both cortical and cancellous bones’ bone mineral density decreased in both groups. With continued usage of BPs, the cortical bone thickness increased.

INTRODUCTION

Due to their increased success rate, dental implants have gained popularity in recent years as a means of replacing missing teeth. As people get older, osteoporosis has been linked to low calcium levels, and women are more likely to experience a decline in bone density. After menopause, women exhibit increased cancellous bone and decreased cortical bone. Treatment with bisphosphonates (BFs) is beneficial in osteoporosis situations. A medication called BF is used to treat certain bone diseases, like osteoporosis, and to prevent bone resorption.[1,2] Osteonecrosis, also referred to as BP-induced osteonecrosis, is more likely to occur in patients receiving BP medication. Lamina dura and cortical boundary thickening are caused by BP.[1]

The goal of the current study was to ascertain how dental implant therapy and BPs affect alveolar bones in post-menopausal women.

MATERIALS AND METHODS

In the current prospective study, 20 post-menopausal women over the age of 55 participated. All had osteoporosis diagnoses, and at least one dental implant was placed within the previous 5 years. The study included patients with either unilaterally or bilaterally edentulous mandibles. The ethical committee granted permission after reviewing the situation.

Ten patients were categorized into two: group A receiving BP medication (Tab Alendronate 10 mg once daily) and group B receiving parathyroid hormone derivative (PTH) (Injection Teriparatide 20 mcg once day).

A CBCT of the posterior edentulous mandibular area was performed on each patient. To measure the BMDs, a phantom with calibration cells holding two comparable amounts of calcium hydroxyapatite was concurrently scanned. The software was used to measure the thickness of the cancellous and cortical bones. For 6 years, the process was repeated each year. The Mann–Whitney test was used to assess the thickness of the cancellous and cortical bones between the two groups, with P 0.05 being considered significant.

RESULT

Group A had 5%, and group B had 5% of dental implants failures. BMD of the cortical bone was 1468 ± 136 mg/mL and 1008 ± 84 mg/mL in groups A and B, correspondingly [Table 1]. Table 2 indicates cortical and cancellous bone densities in both the groups, and they were statically significant (0.05). Cortical bone thickness was insignificant in comparison to both groups [Table 3].

Table 1.

Comparison of various parameters

Parameters	Group A	Group B
Mean age (years)	63.1	64.3
Number of dental implants placed	14	16
Failure cases	1 (5%)	1 (5%)

Table 2.

Bone mineral density (BMD) among groups

Bone mineral density	Group A	Group B	P
BMD of cortical bone (mg/mL)	1468±136	1008±84	0.01
BMD of cancellous bone (mg/mL)	78±12	101±68	0.03

Table 3.

Cortical bone thickness among both groups

Groups	Group A	Group B	P
Cortical bone thickness (mm)	2.1±0.7	2.4±0.9	0.17

DISCUSSION

In both post-menopausal osteoporosis in women and osteoporosis in men, PTH therapy is frequently employed. Patients getting dental implants should be thoroughly screened because there are a few factors that can result in implant failure treatment.[1]

The impact of BPs on dental implant treatment and alveolar bones in post-menopausal women was studied by Pandey et al. They came to the conclusion that both the cortical and cancellous bones’ bone mineral density had decreased in both groups. With continued usage of BPs, the cortical bone thickness increased.[1]

According to Carvas et al., rabbits’ tibial bones had a thicker cortical bone after receiving zoledronic acid.[3] Yip et al. examined the relationship among oral bisphosphonate use and dental implant failure in a study of middle-aged women and found that patients taking oral BPs had a 66.7% worse survival rate for dental implants.[4] According to Suvarna et al., individuals receiving BP medication do not have a materially increased risk of implant failure.[5]

Even if there is a low incidence of osteonecrosis associated with the use of BF, the professional must weigh the risk and use caution to avoid it. Before receiving dental implants, patients receiving BP therapy should undergo a thorough clinical and radiological evaluation. To confirm the findings, additional research is required.

CONCLUSION

Both cortical and cancellous bones’ bone mineral density decreased in both groups. With continued usage of BPs, the cortical bone thickness increased.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.