ABSTRACT
The purposes of this preliminary study are to assess the risk of developing bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a patient with osteoporosis using zoledronic acid and to report the results of a 1-year prospective clinical study regarding 5 immediately inserted implants in the anterior mandible. For this comparative prospective study, 24 female patients, aged ≥54 years, were chosen, all with partially edentulous mandibles. Group A consisted of 12 patients with osteoporosis taking zoledronic acid receiving a once-yearly intravenous infusion of zoledronic acid (5 mg). Control group B consisted of 12 other patients without osteoporosis and not taking drugs. In both groups, the remaining teeth were extracted before 120 implants, 3.7-mm wide and 16-mm long, were immediately installed in the interforaminal region of the mandibles. The 1-year implant survival rate was 100%. No apparent necrotic bone was observed among patients receiving zoledronic acid (group A) after implant surgery. Immediate implant osseointegration can be successful in a patient with osteoporosis using bisphosphonates, suggesting the safety of implantology as a treatment modality.
Subject(s)
Bone Density Conservation Agents/therapeutic use , Dental Implantation, Endosseous/methods , Diphosphonates/therapeutic use , Imidazoles/therapeutic use , Osteoporosis, Postmenopausal/drug therapy , Alveolar Bone Loss/classification , Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology , Bone Density Conservation Agents/administration & dosage , Diphosphonates/administration & dosage , Female , Follow-Up Studies , Humans , Imidazoles/administration & dosage , Infusions, Intravenous , Jaw, Edentulous, Partially/rehabilitation , Jaw, Edentulous, Partially/surgery , Mandible/surgery , Middle Aged , Osseointegration/physiology , Prospective Studies , Risk Factors , Survival Analysis , Tooth Extraction , Tooth Socket/surgery , Zoledronic AcidABSTRACT
AIM: This paper deals with the treatment of an atrophied toothless mandible with a fixing bridge carried by two nonstandard implant systems. METHODOLOGY: Four bicortical screws were implanted into the frontal part of the mandible and one implant on each side was placed into the distal area of the mandible as a support for a fixing bridge. RESULTS: During the years 2002 - 2007 the authors placed a total of 256 bicortical screw and 84 blade implants. During this period only four bicortical screws and one blade implant failed. The primary and secondary surgical success rate was therefore above 98%, while the prosthetic success rate was 100%. (Bridges which had to be re-fabricated due to implant failure were not taken into account.) CONCLUSION: This approach is recommended as a highly successful and affordable option for a wide range of patients.
