Effect of Dental Implants on Bisphosphonate-Related Osteonecrosis of the Jaws

Purpose: Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is a side effect of BP therapy. Dental implants are believed to be a risk factor for developing BRONJ. In the present study, we analyzed the interval to the development of BRONJ in patients treated with BP who had received dental implants. Patients and Methods: Patients with dental implants and established BRONJ were evaluated at the oral and maxillofacial surgery department (Medical University of Vienna). In addition, studies from 1978 to 2012 were included in a meta-analysis. Three groups were created: implantation before BP treatment, implantation after BP treatment, and implantation during BP treatment. The outcomes were evaluated using linear regression analysis. Results: Patients who underwent dental implantation during (P <.001) and after (P <.001) treatment with BPs developed BRONJ more rapidly. The treatment duration with oral BPs was significantly related to the rapidity of developing BRONJ (P =.03). Conclusions: The insertion of dental implants during or after BP treatment accelerated the development of BRONJ. BRONJ occurred less frequently when the implants had been inserted before BP therapy had been started. (C) 2014 American Association of Oral and Maxillofacial Surgeons