The Nature and Frequency of Bisphosphonate-Associated Osteonecrosis of the Jaws in Dental Implant Patients: A South Australian Case Series

Purpose To determine the number of bisphosphonate-associated cases of dental implant failure in South Australia. Materials and Methods All general and specialist dentists who place dental implants in South Australia were contacted and asked to provide information on the total number of implants placed over the decade to December 2007. Cases of bisphosphonate-associated implant failure were identified. Results All 46 practitioners involved in implant placement and the management of bisphosphonate-associated osteonecrosis of the jaws in South Australia were identified. Approximately 28,000 implants had been placed in 16,000 patients. We identified 7 cases of oral bisphosphonate–associated implant failure, with 3 cases of failure of osseointegration and 4 cases of successful implants losing integration after being placed on oral bisphosphonates. There were 5 women and 2 men, and the mean age was 65.7 years (range, 49-75 years). Only 1 was medically compromised, with steroids and diabetes. No cases of implant failure in intravenous bisphosphonate cases were identified. On the basis of the assumption that 5% of the patients were taking an oral bisphosphonate, 1 in 114 (0.89%) had implant failure. Conclusion In patients taking oral bisphosphonates, a failure to integrate or subsequent loss of integration may occur when oral bisphosphonates are started after successful implant placement. The rate of failure is low, at less than 1%.