October 5, 2012
Osteoporosis is a well-known disease that weakens bone and increases the risk of fracture, particularly among postmenopausal women. Biphosphonates, an inhibitor of bone resorption, are widely used as a drug therapy for those with osteoporosis. Prolonged use of biphosphonates, however, can lead to a painful refractory bone exposure in the jaws, known as ”biphosphonate-induced osteonecrosis of the jaw” (BONJ).
This condition usually develops after dental treatment, indicating that oral surgery and implants placed into the jawbone can precipitate BONJ. A study published in the Journal of Oral Implantology involved a total of 54 patients, 8 of them female, who ranged from ages 45 to 68 years. All had been taking oral biphosphonates for less than 3 years; a significant increase in risk of BONJ is associated with more than 3 years of biphosphonate therapy. Immediate occlusal loading procedures were used, which require the motion at the bone-implant interface be kept below a certain threshold during healing. This study demonstrated a 100% success rate, with all patients rehabilitate with a full-arch prosthesis supported by 6 dental implants. Two year of follow-up found no adverse events of infection, tissue swelling, or lesions, showing this to be a viable one-stage treatment. (Source: Journal of Oral Implantology, 2012, Volume 38)