Bisphosphonates and Dental Implants: A Systematic Review and Meta-Analysis

The purpose of the present systematic review was to investigate the influence of bisphosphonates (BPs) on the dental implant failure rate and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, besides a meta-regression in order to verify how the log odds ratio (OR) was associated with follow-up time. The five- and ten-year estimated implant survivals were calculated. The review included 33 publications. Altogether, there were 1727 and 21,986 implants placed in patients taking and not taking BPs, respectively. A pairwise meta-analysis (26 studies) showed that implants in BP patients had a higher failure risk in comparison to non-BP patients (OR 1.653, p = 0.047). There was an estimated decrease of 0.004 in log OR for every additional month of follow-up, although it was not significant (p = 0.259). The global estimated implant survival in patients taking BPs after 5 and 10 years was 94.2% (95% CI, 94.0-94.4) and 90.1% (95% CI, 89.8-90.3), respectively. It was not possible to make any reliable analysis concerning MBL, as only two studies reported MBL results separated by groups. There is a 65.3% higher risk of implant failure in patients taking BPs in comparison to patients not taking this class of drugs.