Group 3 ITI Consensus Report: Materials and antiresorptive drug-associated outcomes in implant dentistry.

Autor: Al-Nawas B; Department for Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the J. Gutenberg University Mainz, Mainz, Germany., Lambert F; Department of Periodontology, Oro-dental and Implant Surgery, CHU of Liège, Liège University, Liège, Belgium.; Dental Biomaterials Research Unit, Liège University, Liège, Belgium., Andersen SWM; Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark., Bornstein MM; Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland., Gahlert M; Private Dental Clinic PD Dr. Gahlert & PD Dr. Roehling, Munich, Germany.; Clinic for Oral and Cranio-Maxillofacial Surgery, Hightech Research Center, University Hospital Basel, University of Basel, Basel, Switzerland.; Sigmund Freud Private University, Vienna, Austria., Jokstad A; Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway., Jung J; Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, South Korea., Kwon YD; Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, South Korea., Laleman I; Department of Periodontology, Oro-dental and Implant Surgery, CHU of Liège, Liège University, Liège, Belgium.; Dental Biomaterials Research Unit, Liège University, Liège, Belgium., Oteri G; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy., Roehling S; Private Dental Clinic PD Dr. Gahlert & PD Dr. Roehling, Munich, Germany.; Clinic for Oral and Cranio-Maxillofacial Surgery, Hightech Research Center, University Hospital Basel, University of Basel, Basel, Switzerland.; Clinic for Oral and Cranio-Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland., Schiegnitz E; Head Division of Implantology, Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany., Takeda Y; Private Dental Clinic, Takeda Dental Clinic, Tokyo, Japan.; Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan., Terheyden H; Department of Oral & Maxillofacial Surgery, Helios Kliniken Kassel, Germany.
Jazyk: angličtina
Zdroj: Clinical oral implants research [Clin Oral Implants Res] 2023 Sep; Vol. 34 Suppl 26, pp. 169-176.
DOI: 10.1111/clr.14135
Abstrakt: Objectives: The aim of Working Group 3 was to address the influence of both material- and anti-resorptive drug- related factors on clinical and biological outcomes and complications in implant dentistry. Focused questions were addressed on (a) implant materials other than titanium (alloy)s, (b) transmucosal abutment materials and (c) medications affecting bone metabolism were addressed.
Materials and Methods: Three systematic reviews formed the basis for discussion in Group 3. Consensus statements and clinical recommendations were formulated by group consensus based on the findings of the systematic reviews. Patient perspectives and recommendations for future research were also conveyed. These were then presented and accepted following further discussion and modifications as required by the plenary.
Results: Zirconia is a valid alternative to titanium as material for implant and transmucosal components, allowing soft and hard tissue integration with clinical outcomes-identified by implant survival, marginal bone loss and peri-implant probing depths-up to 5-years comparable to titatnium. However, most of the evidence for zirconia implants is based on 1-piece implants limiting the indication range. Furthermore, based on expert opinion, zirconia transmucosal components might be preferred in the esthetic zone. In patients receiving low-dose bisphosphonate therapy, the rate of early implant failure is not increased, while the long-term effects remain poorly studied. Although it has not been sufficiently addressed, similar outcomes can be expected with low-dose denosumab. A drug holiday is not recommended when considering implant placement in patients treated with low-dose ARD. However, the specific therapeutic window, the cumulative dose and the administration time should be considered. Access to peri-implant supportive care is mandatory to prevent peri-implantitis-related medication-related osteonecrosis of the jaw (MRONJ) or implant-related sequestra (IRS). In patients receiving low-dose anti-resorptive drugs (ARD) therapy, the risk of complications related to implant placement is high, and implant procedures in this specific population should be strictly treated in a comprehensive multidisciplinary center. Finally, healthy dental implants should not be removed before low or high-dose ARD.
Conclusions: Zirconia implants can be an alternative to titanium implants in selected indications. However, the current state of evidence remains limited, especially for 2-piece implant designs. Administration of low-dose ARD did not show any negative impact on early implant outcomes, but careful follow-up and supportive care is recommended in order to prevent peri-implant MRONJ and IRS. Implant placement in high-dose patients must be strictly considered in a comprehensive multidisciplinary center.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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