Osteonecrosis associated with dental implants in patients undergoing bisphosphonate treatment

作者：Tae‐Geon Kwon, Chung‐O Lee, Jin‐Woo Park, So‐Young Choi, Girdhari Rijal, Hong‐In Shin · 发表于：Clinical Oral Implants Research · 年份：2012 · DOI：10.1111/clr.12088 · 被引用次数：140 · 研究领域：Bone health and treatments、Bone and Joint Diseases、Dental Implant Techniques and Outcomes

OBJECTIVES: Bisphosphonate-related jaw necrosis (BRONJ) associated with dental implants is a rare but continuously reported complication. To verify clinical and pathological characteristics of BRONJ around dental implants, the present study analyzed clinical, radiographic and histopathological findings of these lesions. PATIENTS AND METHODS: Nineteen patients were diagnosed with osteonecrosis of the jaw associated with dental implants and treated at our institute from 2008 to 2011. The patients' medical history, demographic features, radiographic, and histopathological findings along with information on bisphosphonates (BP) administration were analyzed. RESULTS: The majority of BRONJ patients associated with dental implants used oral BP for osteoporosis. The patients were divided into two groups: BP initiation before (n = 16) and after (n = 3) implant surgery. Only three patients (15.8%) could be regarded as "implant surgery-triggered" BRONJ. Many patients (n = 9) showed successful osteointegration after fixture installation to an average of 35 months (11-82 months) until the development of osteonecrosis. The histological features of the lesion showed that the necrotic bone with empty lacunae was infiltrated by inflammatory cells and bacterial colonies. Viable osteocytes were also observed in some areas of the bony specimens. Three types of bone destruction pattern were observed: (i) complete necrosis of the bone around the implant (frozen type), (ii) extensive osteolysis aro...