Autor Doctor&Cols
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Flichy-Fernández AJ, Balaguer-Martínez J, Peñarrocha-Diago M, Bagán JV. Bisphosphonates and dental implants: Current problems. Medicina Oral, Patología Oral y Cirugía Bucal. 2009.
AutoresFlichy-Fernández AJ, Balaguer-Martínez J, Peñarrocha-Diago M, Bagán JV
La osteonecrosis de los maxilares asociada al uso de bifosfonatos es una complicación grave que puede surgir tras procedimientos quirúrgicos orales, incluyendo la colocación de implantes dentales. Esta revisión actualiza la evidencia sobre la relación entre estos fármacos y la osseointegración de implantes. Se contrastan estudios iniciales que sugerían una mejora en la osseointegración con trabajos posteriores que no encontraban diferencias significativas o, más recientemente, advertían sobre el riesgo de necrosis maxilar. Las discrepancias entre estudios en animales y la clínica humana podrían deberse a periodos de tratamiento y seguimiento limitados. Actualmente, se desaconseja la colocación de implantes en pacientes con bifosfonatos intravenosos, y se recomiendan precauciones específicas y consentimiento informado para aquellos en tratamiento oral, considerando la duración y el contexto clínico individual.
Osteonecrosis of the jaw has been described in patients taking bisphosphonates after oral surgery procedures, including the placement of dental implants. This review is an update of the relationship between bisphosphonates and dental implants. Results obtained by different authors are compared, contrasting earlier studies where an improvement in implant osseointegration using bisphosphonates was observed, with ones where statistically significant differences were found, and more recent studies disagreeing with the use of bisphosphonates for causing necrosis of the jaw. The differing results obtained between animal studies and the situation observed in humans may be due to a short medication and follow-up period, as well as to the existence of few research studies where dental implants are placed in the oral cavity. Currently, dental implants are contraindicated in patients being treated with intravenous bisphosphonates. In 2007, the American Association of Oral and Maxillofacial Surgeons suggested guidelines for patients treated with oral bisphosphonates, based on the clinical situation of the patient and the length of treatment with the drug, and that greater caution prior and subsequent to surgery should be taken for three years after treatment. All patients treated with bisphosphonates must have the risk of possible loss of implants and the risk of suffering a bony necrosis of the operated jaw explained to them, and give their informed consent prior to dental implant surgery.
Flichy-Fernández AJ, Balaguer-Martínez J, Peñarrocha-Diago M, Bagán JV. Bisphosphonates and dental implants: Current problems. Medicina Oral, Patología Oral y Cirugía Bucal. 2009.
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