title: Bisphosphonates and dental implants: A meta-analysis.
abstract: OBJECTIVE
  To test the null hypothesis of no difference in the implant failure rates, marginal bone loss, and postoperative infection for patients receiving or not receiving bisphosphonates, against the alternative hypothesis of a difference.
  
  
  METHODS
  An electronic search was undertaken in October 2015 in PubMed/Medline, Web of Science, and Embase, plus hand-searching and databases of clinical trials. Eligibility criteria included clinical human studies, either randomized or not.
  
  
  RESULTS
  A total of 18 publications were included in the review. Concerning implant failure, the meta-analysis found a risk ratio of 1.73 (95% confidence interval [CI] 1.21-2.48, P = .003) for patients taking bisphosphonates, when compared to patients not taking the medicament. The probability of an implant failure in patients taking bisphosphonates was estimated to be 1.5% (0.015, 95% CI 0.006- 0.023, standard error [SE] 0.004, P < .001). It cannot be suggested that bisphosphonates may affect the marginal bone loss of dental implants, due to a limited number of studies reporting this outcome. Due to a lack of sufficient information, meta-analysis for the outcome "postoperative infection" was not performed.
  
  
  CONCLUSIONS
  The results of the present study cannot suggest that the insertion of dental implants in patients taking BPs affects the implant failure rates, due to a limited number of published studies, all characterized by a low level of specificity, and most of them dealing with a limited number of cases without a proper control group. Therefore, the real effect of BPs on the osseointegration and survival of dental implants is still not well established.
authors.forename: Bruno Ramos
authors.initials: BR
authors.lastname: Chrcanovic
authors.forename: Tomas
authors.initials: T
authors.lastname: Albrektsson
authors.forename: Ann
authors.initials: A
authors.lastname: Wennerberg
mesh_terms: D016301:Alveolar Bone Loss / Q000150:complications; D015921:Dental Implants; D019232:Dental Restoration Failure; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D016348:Osseointegration / Q000187:drug effects*; D013530:Surgical Wound Infection / Q000209:etiology
chemical_list: D015921:Dental Implants; D004164:Diphosphonates