Osteoporosis: Can I still have Dental Implants?

Osteoporosis: Can I still have Dental Implants?

Dental Monthly

By Dr. Elena Speranza Moll

 

We know that Osteoporosis is a medical condition in which the bones become brittle and fragile from loss of mineralization.

The lifelong remodeling of the bone, also called Bone Metabolism, is actually a balance between bone absorption and bone regeneration. But with age and/or hormonal changes, with calcium or vitamin D deficiency, this balance skips in favor of bone-resorption and you slowly develop first Osteopenia that can then become Osteoporosis.

We also know that substituting a lost tooth with a Dental Implant is one of the best solutions. But Implants, like screws in the wall, need good foundations, healthy strong bones.
So to the question: “Can I still have Dental Implants with my osteoporosis?” The answer is: “It depends”.

There are 2 factors influencing my decision to go ahead with implant surgery or not.

Factor 1/ What level of Osteopotrosis has been diagnosed?
A/ With mere Osteopenia there are NO CONTRAINDICATIONS
B/ Osteoporosis with moderate bone loss in the implant site has NO CONTRAINDICATIONS
C/ Osteoporosis with severe bone loss in the implant site has a RELEVANT CONTRAINDICATION
D/ Osteoporosis with spontaneous fractures elsewhere in the body is a CONTRAINDICATION

Factor 2/ How is your Osteoporosis being cured?
A/ If you are taking food supplements like Osteo B-plus and extra vitamin D, lifestyle adjustments and exercise etc. There are NO CONTRAINDICATIONS

B/ If you are taking Biphosphonates to prevent fractures or loss of mineralization that is an ABSOLUTE CONTRAINDICATION
I would definitely renounce implant surgery or extractions or any operation that involves the bone in this case. Biphosphonates, which are used also in Chemotherapy, stop Bone-Metabolism and this prevents the loss of bone. This means no more resorption, hence no more fractures. But it is precisely the remodeling of the bone that is essential in implant surgery and without these healing processes an implant, as well as an extraction and other bone surgeries, can result in severe Osteonecrosis, which means that the bone cells will die and dead bone blocks will be rejected (think of hair-loss in Chemotherapy patients) and this can take many months of pain and healing, resulting in huge bone defects.

Conclusions
>All cases of Osteoporosis or Osteopenia without contraindications can be treated with dental implants in combination with guided bone regeneration to strengthen and where needed regenerate bone, which is important for implant stability and long prognosis.
>If patients use Biphosphonates for a long time due to Osteoporosis and need dental implants usually a medicine holiday of several years – up to 3 years – is recommended to be sure that the Bone Metabolism is normalized and all the Biphosphonates are eliminated from the bone.

>If patients are using Biphosphonates as part of a Chemotherapy then usually once that has come to an end, as it is a shorter period of use, it takes about a year to be able to do the implant surgery safely.
>Implants that are already present in patients using Biphosphonates are not at special risk, but as always extra attention is needed to prevent inflammation of the gums, so-called periimplantitis.
Advice: Always tell your Dentist what medication you are on to prevent problems after treatments.
Try to avoid long-term use of Biphosphonates. Especially here in Italy they are too easily prescribed without informing the patient of their side effects, so look for alternative therapies if possible.

Studio Moll

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