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Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis

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Abstract

Purpose

This systematic review and meta-analysis aimed to compare the dental implant survival rate and marginal bone loss between patients with and without osteoporosis.

Materials and methods

This systematic review was registered in PROSPERO (CRD42022356377). A systematic search was performed using five databases: MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to July 2022. Additional searches in ClinicalTrials.gov and the reference lists of included studies were performed. The eligibility criteria comprised observational studies with a direct comparison between patients with and without osteoporosis, with a minimum follow-up of 1 year and 10 implants placed in each group, which consider data analysis based on implant level, without restrictions on period or language of publication. The meta-analysis was performed using RevMan 5.4 program. Risk of bias analysis of the included studies was performed using the Newcastle–Ottawa scale (NOS).

Results

Twelve studies met the eligibility criteria, totaling 1132 patients with a mean age range from 54 to 76.6 years. Most of the included patients were women (73.6%). A total of 3505 implants were evaluated—983 in patients with osteoporosis and 2522 in patients without osteoporosis. The meta-analysis indicated no difference in implant survival rates between patients with and without osteoporosis (OR, 1.78; 95% confidence interval [CI], 0.86–3.70; P = 0.12). However, significant bone loss was observed around dental implants placed in patients with osteoporosis (SMD, 0.71 mm; 95% CI, 0.06–0.87 mm). The NOS indicated a low risk of bias in the studies included. However, the certainty of the evidence was classified as very low and low for implant survival rates and bone loss, respectively.

Conclusion

According to the limitations of the present review, the data suggest that dental implants are a viable treatment option for the rehabilitation of patients with osteoporosis. However, clinical care by professionals is necessary to ensure the maintenance of peri-implant bone stability, as these patients may be susceptible to increased bone loss.

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Data availability

All data are within the manuscript.

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Funding

This work was Supported by the PhD Scholarship of São Paulo Research Foundation (FAPESP #2015/24442–8) and Scientific Initiation – PIBIC of Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) – Federal University of Juiz de Fora (UFJF/GV: Id 47585).

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Authors and Affiliations

  1. Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil

    Cleidiel Aparecido Araujo Lemos & Andreza Soares de Oliveira

  2. Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil

    Daniele Sorgatto Faé

  3. Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil

    Hiskell Francine Fernandes e Oliveira, Cleber Davi Del Rei Daltro Rosa, Victor Augusto Alves Bento, Fellippo Ramos Verri & Eduardo Piza Pellizzer

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  1. Cleidiel Aparecido Araujo Lemos
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Contributions

C.A.A.L and A.S.O. received scholarship funding; C.A.A.L. and F.R.V. wrote the main manuscript text; C.A.A.L and E.P.P. were responsible for concept of this article; A.S.O. and D.S.F. performed searches in the databases; A.S.O. and H.F.F.O. extracted data of the included articles; C.D.D.R.D.R. and V.A.A.B. were responsible to evaluate the quality assessment of included articles; F.R.V and C.A.A.L. performed meta-analysis). All authors performed a critical revision of article, approval and reviewed the manuscript.

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Correspondence to Cleidiel Aparecido Araujo Lemos.

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Lemos, C.A.A., de Oliveira, A.S., Faé, D.S. et al. Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis. Clin Oral Invest 27, 2483–2493 (2023). https://doi.org/10.1007/s00784-023-05005-2

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