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Medication Related Osteonecrosis of the Jaw and Implant Failure in Patients under Antiresorptive Medication for Non-malignant Diseases - A Systematic Review
Malmö University, Faculty of Odontology (OD).
Malmö University, Faculty of Odontology (OD).
2018 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [sv]

Sammanfattning Syfte: Att genomföra en systematisk litteraturöversikt av antiresorptiva läkemedels påverkan på käkbenet i anslutning till intraosseösa dentala implantat. Material och metod: Elektronisk sökning utfördes i PubMed, med hjälp av MeSH-termer och fria sökord, enligt interventionen från PICOS-strategin. Söktermerna anpassades sedan för sökning i databaserna Cochrane och Scopus. Resultat: Tre prospektiva observationsstudier, 17 retrospektiva observationsstudier och två systematiska litteraturstudier inkluderades för dataextraktion. Åtta studier hade antingen MRONJ, implantatmisslyckande eller båda som utfall och presenterade sedan de drabbade patientfallen. 12 studier undersökte resultatet av implantatbehandling hos patienter med an-tiresorptiv medicinering avseende implantatmisslyckande. Sju av dessa studier hade också MRONJ som utfall. Det fanns inga tecken på MRONJ i någon studie och antalet misslyckade implantat var lågt. Slutsats: Baserat på presenterad data kan inga slutsatser dras från nuvarande studier avseende misslyckande implantatbehandlingar och utveckling av MRONJ vid implantatinstallation på patienter med antiresorptiv medicinering för icke-maligna sjukdomar. Tills vidare bör dessa patienter behandlas med försiktighet och besluten måste fattas enligt fördelar/risker för den enskilda individen. Alla förebyggande åtgärder, såsom atraumatisk kirurgiteknik, optimering av munhygien och regelbundna uppföljningar, bör vidtas för att minimera potentiella riskfak-torer. Prospektiva kontrollstudier utförda på större populationer och med längre uppföljning behövs för att fastställa vetenskaplig evidens på detta ämne.

Abstract [en]

Abstract Objective: To conduct a systematic review of the influence of antiresorptive medication on the jaw bone tissue in connection with intraosseous dental implants. Material and Methods: Electronic search was carried out in PubMed, using MeSH-terms and Keywords, according to the intervention of the PICOS strategy. The search was then modi-fied for Cochrane and Scopus databases. Results: Three prospective observational studies, 17 retrospective observational studies and two systematic reviews were included for data extraction. Eight studies had either MRONJ (Medication Related OsteoNecrosis of the Jaws), implant failure or both as outcome and pre-sented the characteristics of the affected patients. 12 studies examined the outcome of im-plant treatment in patients with antiresorptive medication regarding implant failure. Seven of these studies also had occurrence of MRONJ as outcome. There were no signs of MRONJ as a result in any study and the number of failed implants were low in general. Conclusion: Based on the presented data, no conclusions can be drawn from present studies about the safety of dental implant treatment on patients with antiresorptive medication for non-malignant diseases, regarding implant failure and development of MRONJ. Until further, these patients should be treated with caution, and the decisions have to be made according to the benefits/risks on an individual basis. All actions such as atraumatic surgery procedures, optimization of the oral hygiene and regular follow-ups should be taken to minimize potential risk factors. Prospective, controlled studies performed on larger populations and with longer follow-up are needed to establish the scientific evidence on this subject.

Place, publisher, year, edition, pages
Malmö universitet/Odontologiska fakulteten , 2018. , p. 27
Keywords [en]
MRONJ, Dental implants
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-19674Local ID: 25620OAI: oai:DiVA.org:mau-19674DiVA, id: diva2:1479518
Educational program
OD Tandläkarutbildning
Supervisors
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Available from: 2020-10-27 Created: 2020-10-27 Last updated: 2022-06-27Bibliographically approved

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