Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis

Author(s)

Araujo Lemos, Cleidiel Aparecido ; de Oliveira, Andreza Soares ; Fae, Daniele Sorgatto ; Fernandes e Oliveira, Hiskell Francine ; Del Rei Daltro Rosa, Cleber Davi ; Alves Bento, Victor Augusto ; Verri, Fellippo Ramos ; Pellizzer, Eduardo Piza

• Document type: Journal article
• Source: CLINICAL ORAL INVESTIGATIONS; v. 27, n. 6, p. 11-pg., 2023-04-12.

Abstract

PurposeThis systematic review and meta-analysis aimed to compare the dental implant survival rate and marginal bone loss between patients with and without osteoporosis.Materials and methodsThis systematic review was registered in PROSPERO (CRD42022356377). A systematic search was performed using five databases: MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to July 2022. Additional searches in ClinicalTrials.gov and the reference lists of included studies were performed. The eligibility criteria comprised observational studies with a direct comparison between patients with and without osteoporosis, with a minimum follow-up of 1 year and 10 implants placed in each group, which consider data analysis based on implant level, without restrictions on period or language of publication. The meta-analysis was performed using RevMan 5.4 program. Risk of bias analysis of the included studies was performed using the Newcastle-Ottawa scale (NOS).ResultsTwelve studies met the eligibility criteria, totaling 1132 patients with a mean age range from 54 to 76.6 years. Most of the included patients were women (73.6%). A total of 3505 implants were evaluated-983 in patients with osteoporosis and 2522 in patients without osteoporosis. The meta-analysis indicated no difference in implant survival rates between patients with and without osteoporosis (OR, 1.78; 95% confidence interval [CI], 0.86-3.70; P = 0.12). However, significant bone loss was observed around dental implants placed in patients with osteoporosis (SMD, 0.71 mm; 95% CI, 0.06-0.87 mm). The NOS indicated a low risk of bias in the studies included. However, the certainty of the evidence was classified as very low and low for implant survival rates and bone loss, respectively.ConclusionAccording to the limitations of the present review, the data suggest that dental implants are a viable treatment option for the rehabilitation of patients with osteoporosis. However, clinical care by professionals is necessary to ensure the maintenance of peri-implant bone stability, as these patients may be susceptible to increased bone loss. (AU)

• FAPESP's process: 15/24442-8 - Biomechanical analysis of implant-supported prosthesis varying the type connection, the retention system, restorative material, type and level of bone tissue. Study by three-dimensional finite element method.
• Grantee: Cleidiel Aparecido Araujo Lemos
• Support Opportunities: Scholarships in Brazil - Doctorate