Dental implants and oral bisphosphonates: What is the risk of osteonecrosis?
Dental implants are prosthetic rehabilitations that mimic the teeth and serve to treat edentulous patients. Bisphosphonates are medicines used to strengthen and reshape bones. Since the target of the implant are patients without teeth that usually have bone insufficiency in the mouth, bisphosphonates are great allies of this treatment. Despite this, its use is controversial because it can cause osteonecrosis (bone tissue death) of the maxilla and mandible, among other adverse effects (gastrointestinal intolerance, ulcers, esophageal erosions, renal failure and myalgia). Some criteria must be considered for the responsible prescription of biophosphonates. These are the participation of other professionals (physicians, physiotherapists, psychologists and specialists in oral and maxillofacial surgery) together with the dental surgeon to evaluate the best treatment, analysis of risk factors for osteonecrosis (age, alcohol consumption, high cholesterol , among others) and the association of medications or surgical interventions in order to avoid it. It is concluded that although oral biophosphates offer risks of bone necrosis, they are a good alternative to help some cases of implantology treatments. And it is important that the dental surgeon be aware of the other resources for patients with contraindication of this medicine.