Systemic Bisphosphonate Application as a Risk Factor in Dental Implantology

In patients treated with oral or intravenously administered bisphosphonates, the question arises whether these patients can achieve dental implants or augmentation procedures due to prosthetic rehabilitation. The current guideline of the German Society of Oral and Maxillofacial Surgery (DGMKG, May 2007) implies the implant treatment as contraindicated only in patients who already suffered from BP-ONJ (recommendation grade A). However, in patients who are taking oral bisphosphonates without symptoms of BP-ONJ there is no clear directive due to the limited data available. Based on a literature analysis, this paper attempts to give an overview on the latest findings concerning BP-ONJ. The recommendations presented are not imperative in nature and should only help the implantologists to identify risk patients and help about the decision whether implant treatment is an option for their patients under bisphosphonate therapy.