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- W2973765128 abstract "Introduction:A growing number of cancer and osteoporosis patients undergoing biphosphonate treatment develop osteonecrotic lesions of the maxillary bones. For a long time, it was widely held that surgical therapy should be avoided in such patients. While the current guidelines have clarified many surgical issues, the debate on the indications for prosthetic implants remains open.Aims:The aim of this study was to develop and document a simple, safe and effective surgical and pharmacological protocol for the prosthetic implant treatment of patients with a history of biphosphonate use.Materials and methods:The authors retrospectively analysed a series of 15 patients under chronic treatment with biphosphonates submitted to oral implant rehabilitation. In 6 cases, clodronate was administered prior to the implant surgery, in 4 cases alendronate, and in 5 cases, risedronate. Only patients receiving significant cumulative doses of monoamine biphosphonates (at least 3 years of treatment) were analysed. Rehabilitation of the patients considered in the study was performed by means of overdentures on implants. The indication for this procedure was the presence of mandibular atrophy and total edentulism. Implants were placed in interforaminal sites in the anterior mandibular region. The patients underwent serum measurement of biochemical markers indicative of bone metabolic activity (cross-linked c telopeptide of type I collagen) in order to document their risk of ONJ. The implant fixtures were loaded 3 months after being inserted.Results:In the intra-operative phase, we observed significantly increased single fixture screw torque; primary stability was excellent and tissue vascularisation was also normal. No morbidity was observed at 24-months follow up, and radiological follow-up examinations showed optimal osseointegration of the implants and no gaps suggesting premature deterioration. The cumulative survival curve was 100% for all implants at 24 months and mean crestal bone loss at the level of the implant-abutment junction was 0.8 mm (s.d. 1.0).Conclusions:The chemical structure of biphosphonates together with the right implant system can influence outcome. In these patients, we observed high serum levels of biochemical bone markers, however we do not have sufficient data to correlate this finding with low surgical risk." @default.
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- W2973765128 date "2010-01-01" @default.
- W2973765128 modified "2023-09-27" @default.
- W2973765128 title "P19 - Monitoring of Bone Metabolism in Candidates for Prosthetic Implants under Chronic Biphosphonate Treatment." @default.
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