Outcome of healing after dental implant placement in patients with cancer on high-dose antiresorptive medications: a prospective feasibility study

Oral Maxillofac Surg. 2023 Mar;27(1):89-100. doi: 10.1007/s10006-022-01042-5. Epub 2022 Jan 27.

Abstract

Purpose: Implant placement in patients with cancer receiving high-dose antiresorptive medication (HDAR) is considered contraindicated. This prospective, feasibility study tested the hypothesis that dental implants can be placed in such patients by applying a staged implant placement protocol with submerged healing.

Methods: Three groups of patients on HDAR were included as follows: group 1: patients who underwent tooth extraction, without the development of medication-related osteonecrosis of the jaws (MRONJ); group 2: patients with surgically treated MRONJ who had demonstrated clinical healing for at least 3 months; group 3: patients with established MRONJ who was planned for surgical resection and simultaneous implant placement.

Results: A total of 49 implants were placed in 27 patients (group 1: 12, group 2: 7 and group 3: 8). HDAR included bisphosphonates and denosumab. The mean HDAR time was 25 months (SD: ± 18.4, range 3-68 months). An abutment operation was performed 4 months following the implant placement (SD: ± 1.9, range 3-14 months). All patients healed uneventfully.

Conclusions: This study demonstrated that it is feasible to insert dental implants and perform an abutment surgery in patients with cancer on HDAR, without the development of MRONJ.

Clinicaltrials: gov Identifier: NCT04741906.

Keywords: Antiresorptive agents; Cancer; Dental implant; Prosthodontics.

MeSH terms

  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / diagnostic imaging
  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / drug therapy
  • Bisphosphonate-Associated Osteonecrosis of the Jaw* / surgery
  • Bone Density Conservation Agents* / adverse effects
  • Dental Implants*
  • Feasibility Studies
  • Humans
  • Neoplasms* / chemically induced
  • Neoplasms* / drug therapy
  • Prospective Studies

Substances

  • Dental Implants
  • Bone Density Conservation Agents

Associated data

  • ClinicalTrials.gov/NCT04741906