• Like
Bisphphonates related peri implantitis
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Bisphphonates related peri implantitis

  • 224 views
Published

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
224
On SlideShare
0
From Embeds
0
Number of Embeds
2

Actions

Shares
Downloads
16
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Implants and bisphosphonate therapy Dealing with a complication - Our experience CLD 948 - 03/27/2014 Dr. Nicola Alberto Valente
  • 2. Patient Data • 71 years old • Female • Caucasian • Non-smoker
  • 3. Referral • 10/2012 Implant #12 follow up (last cleaning in 2009) • Implant was placed 8/10/2009 in fresh extraction socket (Nobel Replace, tapered groovy 4.3x13mm.
  • 4. Medical history • Breast cancer removal in 2005 (Lymph node removed in 2006) • Thyroid lobe removed (1980’s) • Glaucoma • Allergic to latex
  • 5. Current Medications • Timoptic eye drops (Beta-blocker) • Aspirin 81mg • Multi-vitamin
  • 6. Past Medications • Arimidex (anastrozole, antineoplastic agent, aromatase inhibitor) 1mg/day for breast cancer. An important side effect is decrease in mineral bone density • Actonel (Risedronate) 35mg once a week. Started in 2006, stopped in october 2010 The patient was taking bisphosphonates at the time of implant placement. She signed consent form.
  • 7. Past Medications • Arimidex (anastrozole, antineoplastic agent, aromatase inhibitor) 1mg/day for breast cancer. An important side effect is decrease in mineral bone density • Actonel (Risedronate) 35mg once a week. Started in 2006, stopped in october 2010 The patient was taking bisphosphonates at the time of implant placement. She signed consent form.
  • 8. Actonel medication guide SIDE EFFECTS: […] Severe jaw bone problems (osteonecrosis). Severe jaw bone problems may happen when you take Actonel. Your doctor should examine your mouth before you start Actonel. Your doctor may tell you to see your dentist before you start Actonel. It is important for you to practice good mouth care during treatment with Actonel. […]
  • 9. Gurpreet K. Chadha, Azadeh Ahmadieh, Satish Kumar, and Parish P. Sedghizadeh (2013) Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review. Journal of Oral Implantology: August 2013, Vol. 39, No. 4, pp. 510-520. […] Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations, and hence results must be interpreted in this context. […]
  • 10. ! Javed F, Almas K. Osseointegration of dental implants in patients undergoing bisphosphonate treatment: a literature review. J Periodontol. 2010 Apr;81(4):479-84. […] Two studies (out of 12) showed a negative impact of BPs on implant success. […] […] Dental implants can osseointegrate and remain functionally stable in patients using BPs. […]
  • 11. Madrid C, Sanz M. What impact do systemically administrated bisphosphonates have on oral implant therapy? A systematic review. Clin Oral Implants Res. 2009 Sep;20 Suppl 4:87-95. […] From the analysis of the one prospective and the three retrospective series (217 patients), the placement of an implant may be considered a safe procedure in patients taking oral BPs for <5 years with regard to the occurrence of BRONJ since in these studies no BRONJ has been reported. Moreover, the intake of oral-BPs did not influence short-term (1-4 years) implant survival rates. […]
  • 12. • Local antibiotic delivery: Arestin (minocycline) • Follow-up at 6 weeks revealed no changes. Subgingival irrigation with chlorhexidine gluconate 0.12% was performed Bassetti M, Schär D, Wicki B, Eick S, Ramseier CA, Arweiler NB, Sculean A, Salvi GE. Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: 12-month outcomes of a randomized controlled clinical trial. Clin Oral Implants Res. 2014 Mar;25(3):279-87.
  • 13. follow up 2.5 months Marx RE. Bisphosphonate-induced osteonecrosis of the jaws: a challenge, a responsibility, and an opportunity. Int J Periodontics Restorative Dent. 2008 Feb;28(1):5-6.
  • 14. Follow up 1 week
  • 15. Follow up 2 weeks suture removal
  • 16. Cycle of 4 laser soft tissues biostimulation 1 week after first session Fernanda G. Basso, Taisa N. Pansani, Ana Paula S. Turrioni, Vanderlei S. Bagnato, Josimeri Hebling, and Carlos A. de Souza Costa, “In Vitro Wound Healing Improvement by Low-Level Laser Therapy Application in Cultured Gingival Fibroblasts,” International Journal of Dentistry, vol. 2012, Article ID 719452, 6 pages, 2012.
  • 17. 9 months follow up Nevins M, Giannobile WV, McGuire MK, Kao RT, Mellonig JT, Hinrichs JE, McAllister BS, Murphy KS, McClain PK, Nevins ML, Paquette DW, Han TJ, Reddy MS, Lavin PT, Genco RJ, Lynch SE. Platelet-derived growth factor stimulates bone fill and rate of attachment level gain: results of a large multicenter randomized controlled trial. J Periodontol. 2005 Dec; 76(12): 2205-15.
  • 18. 9 months follow up Nevins M, Giannobile WV, McGuire MK, Kao RT, Mellonig JT, Hinrichs JE, McAllister BS, Murphy KS, McClain PK, Nevins ML, Paquette DW, Han TJ, Reddy MS, Lavin PT, Genco RJ, Lynch SE. Platelet-derived growth factor stimulates bone fill and rate of attachment level gain: results of a large multicenter randomized controlled trial. J Periodontol. 2005 Dec; 76(12): 2205-15.
  • 19. 9 months follow up Nevins M, Giannobile WV, McGuire MK, Kao RT, Mellonig JT, Hinrichs JE, McAllister BS, Murphy KS, McClain PK, Nevins ML, Paquette DW, Han TJ, Reddy MS, Lavin PT, Genco RJ, Lynch SE. Platelet-derived growth factor stimulates bone fill and rate of attachment level gain: results of a large multicenter randomized controlled trial. J Periodontol. 2005 Dec; 76(12): 2205-15.
  • 20. Thank you