An open, prospective, non-randomized, controlled, multicentre study to evaluate the clinical outcome of implant treatment in women over 60 years of age with osteoporosis/osteopenia: 1-year results

Abstract

Background: Osteoporosis has been called a potential risk factor for bone healing around implants.

Aim: The aim of this multicentre study was to verify the clinical performance of fluoridated implants in the maxilla of subjects with diagnosed systemic primary osteoporosis/osteopenia.

Material and methods: Postmenopausal women in need of 2-8 splinted implants in maxilla underwent bone mineral density measurements in the hip and spine, using dual-energy X-ray absorptiometry scans. Based on their T-scores, they were divided into two study groups: Group O (osteoporosis/osteopenia group) subjects had a T-score ≤-2, Group C (control group) had a T-score of ≥-1, and subjects with a T-score <-1 but >-2 were excluded. Implants were placed with a two-stage procedure and loaded 4-8 weeks after abutment surgery. At 6 months and 1 year after functional loading, clinical parameters (including peri-apical radiographs) were assessed.

Results: One hundred and forty-eight implants were placed in 48 subjects (mean age: 67 years (range [59-83]). Sixty-three implants were placed in 20 osteoporosis subjects (Group O, mean age: 69 years; range [59-83]), and 85 were placed in control subjects (Group C, mean age: 65 years; range [60-74]). The cumulative survival rate, on an implant level, was 99.3% (Group O: 98.4%; Group C: 100.0%). The cumulative survival rate, on a subject level, was 97.9% (Group O: 94.7%; Group C: 100.0%). Marginal bone level (MBL) alterations from functional loading to the 1-year follow-up visit were measured on an implant level and a subject level. The overall MBL alteration on an implant level was -0.01 ± 0.51 mm (Group O: -0.11 ± 0.49 mm; Group C: 0.05 ± 0.52 mm). The overall MBL alteration on a subject level was -0.04 ± 0.27 mm (Group O: -0.17 ± 0.30 mm; Group C: 0.04 ± 0.23 mm).

Conclusion: Within the limitations of this prospective, non-randomized, controlled, multicentre study, it can be concluded that oral implant therapy in patients suffering from osteoporosis/osteopenia is a reliable treatment option with comparable integration rates as in healthy patients. Long-term follow of the study groups is necessary to compare marginal bone alterations and treatment outcomes.

Keywords: ASTRA TECH implant system; dental implants; marginal bone loss; osteoporosis.