Effect of local zoledronate delivery on osseointegration: a systematic review of preclinical studies

Purpose: The aim of the present systematic review was to assess the effect of local zoledronate (ZOL) delivery (topical or as implant surface coatings) on osseointegration. Materials and methods: In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. To address the focused question, 'Does local zoledronate delivery enhance osseointegration?' indexed databases were searched without time or language restrictions up to and including April 2017 using various combination of the following keywords: 'zoledronate', bisphosphonates', 'osseointegration' and topical administration'. Letters to the Editor, historic reviews, commentaries, case-series and case-reports were excluded. Results: Initially, 383 articles were identified out of which, 23 experimental studies fulfilled the inclusion criteria. In 18 studies, ZOL was incorporated into implants surfaces as a coating and in five studies ZOL was applied topically (bone graft or irrigation) into the bone cavities. Results from 87% studies reported that local delivery of ZOL (coating or topical) is effective in enhancing osseointegration or new bone formation around implants. Conclusions: Local ZOL delivery (coating or topical) seems to enhance osseointegration in animals; however, from a clinical perspective, further randomized control trials with long-term follow-up are needed in this regard.