title: Effect of dental implants on bisphosphonate-related osteonecrosis of the jaws.
abstract: OBJECTIVE
  Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is a side effect of BP therapy. Dental implants are believed to be a risk factor for developing BRONJ. In the present study, we analyzed the interval to the development of BRONJ in patients treated with BP who had received dental implants.
  
  
  METHODS
  Patients with dental implants and established BRONJ were evaluated at the oral and maxillofacial surgery department (Medical University of Vienna). In addition, studies from 1978 to 2012 were included in a meta-analysis. Three groups were created: implantation before BP treatment, implantation after BP treatment, and implantation during BP treatment. The outcomes were evaluated using linear regression analysis.
  
  
  RESULTS
  Patients who underwent dental implantation during (P < .001) and after (P < .001) treatment with BPs developed BRONJ more rapidly. The treatment duration with oral BPs was significantly related to the rapidity of developing BRONJ (P = .03).
  
  
  CONCLUSIONS
  The insertion of dental implants during or after BP treatment accelerated the development of BRONJ. BRONJ occurred less frequently when the implants had been inserted before BP therapy had been started.
authors.affiliation: Resident, University Clinic of Craniofacial, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: daniel.holzinger@meduniwien.ac.at.
authors.forename: Daniel
authors.initials: D
authors.lastname: Holzinger
authors.affiliation: Professor, University Clinic of Craniofacial, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Seemann
authors.affiliation: Resident, University Clinic of Craniofacial, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Nadja
authors.initials: N
authors.lastname: Matoni
authors.affiliation: Professor, University Clinic of Craniofacial, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Rolf
authors.initials: R
authors.lastname: Ewers
authors.affiliation: Head of Department, Institute of Oral and Maxillofacial Surgery and Dentistry, Krankenhaus Hietzing, Vienna, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Millesi
authors.affiliation: Professor, University Clinic of Craniofacial, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Arno
authors.initials: A
authors.lastname: Wutzl
mesh_terms: D000367:Age Factors; D000368:Aged; D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects; D002908:Chronic Disease; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects; D019232:Dental Restoration Failure; D020878:Device Removal; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D015921:Dental Implants; D004164:Diphosphonates