Pharmacologic augmentation of implant fixation in osteopenic bone

Curr Osteoporos Rep. 2014 Mar;12(1):55-64. doi: 10.1007/s11914-013-0182-z.


Osteoporosis presents a challenge for successful implant fixation due to an impaired healing response. Preclinical studies have consistently reported reduced osseointegration capability in trabecular bone. Although clinical studies of implant success in dentistry have not found a negative effect due to osteoporosis, low bone mass is a significant risk factor for implant migration in orthopedics. Pharmacologic treatment options that limit bone resorption or upregulate formation have been studied preclinically. While, both treatment options improve implant fixation, direct comparisons to-date have found anti-catabolic more effective than anabolic treatments for establishing implant fixation, but combination approaches are better than either treatment alone. Clinically, anti-catabolic treatments, particularly bisphosphonates have been shown to increase the longevity of implants, while limited clinical evidence on the effects of anabolic treatment exists. Preclinical experiments are needed to determine the effects of osteoporosis and subsequent treatment on the long-term maintenance of fixation and recovery after bone loss.

Publication types

  • Review

MeSH terms

  • Animals
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Diseases, Metabolic / complications
  • Bone Diseases, Metabolic / therapy
  • Calcitonin / therapeutic use*
  • Combined Modality Therapy
  • Diphosphonates / therapeutic use*
  • Fracture Fixation / methods*
  • Fractures, Bone / complications
  • Fractures, Bone / therapy
  • Humans
  • Orthopedic Fixation Devices
  • Osseointegration
  • Osteoporosis / therapy*
  • Osteoporotic Fractures / therapy*
  • Parathyroid Hormone / therapeutic use*
  • Prostheses and Implants
  • Thiophenes / therapeutic use


  • Bone Density Conservation Agents
  • Diphosphonates
  • Parathyroid Hormone
  • Thiophenes
  • strontium ranelate
  • Calcitonin