Naslov
ANKYLOS dental implants in patient at risk of bisphosphonate-induced jaw necrosis

Autori
Brajdić, Davor ; Macan, Darko ; Dukić, Valter

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, neobjavljeni rad, stručni

Izvornik
13th DENTSPLY Friadent World Symposium. Berlin, 18.-19.4.2008. / - , 2008

Skup
13th DENTSPLY Friadent World Symposium

Mjesto i datum
Berlin, Njemačka, 18.04.2008. - 19.04.2008

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
dental implants ; bisphosphonates ; osteonecrosis

Sažetak
We report a case of a 74-year-old female patient, which was a candidate for dental implants but suffered from osteoporosis and was on oral bisphosphonate therapy. Osteoporosis was diagnosed 5 years ago and she started therapy with Fosamax® ; ; (Merck). Patient visited outpatient dental office because of total anodontia but insufficient maxillary residual alveolar ridge for total mobile prosthesis. Mandibular alveolar ridge was partially hypodontic, Kennedy class I, with sufficient partial prosthesis. The specialist suggested dental implants and referred the patient to Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia. After clinical exam, radiological and endocrinological consultation, we inserted two Ankylos implants in both canine areas for two ball attachments. We informed endocrinologist that we intend to perform "drug holiday" for minimum 3 months prior, and 3 months postoperatively. According to the last DEXA- scan, he decided to allow our treatment. Three months before implants were positioned, patient stopped therapy with Fosamax® ; ; (Merck). One of the implants was positioned with bone expanders and condensers Ankylos® ; ; (Dentsply, Friadent) because of the narrow horizontal ridge dimension. Implants had primary stability. We used Ankylos® ; ; (Dentsply, Friadent) A 11 implants. Three months after implantations, radiological finding was excellent and we placed two ball attachments. Near after, a total prosthesis was made and the satisfied patient started again with Fosamax® ; ; (Merck) therapy. On follow-up visit one year later, clinical and radiological finding was good. The doubt was if we even could perform implants in patients on bisphosphonates, and if we could, in which cases is it possible? Today’ s literature says to avoid it in patients, which are on intravenous bisphosphonate therapy because of high risk of BRON (Bisphosphonate Related Osteonecrosis). It is possible to perform implant surgery in patients which are on oral bisphosphonates, but under special circumstances: 1. the patient is less then 3 years on therapy ; 2. if the patient is less than 3 years on therapy, but is on corticosteroid therapy, or the patient is longer than 3 years on therapy, it is recommended "drug holiday" minimum 3 months prior and also postoperatively, and 3. if the patient had BRON earlier but is cured, and isn't on bisphosphonates anymore, it is possible to perform implant surgery. Supported by Croatian Ministry of Science, Education and Sport Grant 065-1080057-0429

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Dentalna medicina

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