Objective: Osteoporosis is the most common systemic bone disease that is associated with an increased risk for fractures. If osteoporosis can be considered a risk factor for compromised osseointegration is not clear. The aim of the study was to evaluate the impact of osteoporosis on the success rates of dental implants based on a systematic review.
Material and Method: The last electronic search in the database MEDLINE was conducted on 1. November 2009 based on the key words "osteoporosis and dental implants". Hand searching included journals which were cross-referenced. The search was limited to clinical studies in English.
Endpoints were the number of osseointegrated and lost implants in controlled studies with osteoporosis and non-osteoporosis patients.
Results: Thirty-three clinical trials were identified. Nine trials including over 1511 patients were included. Three trials enrolled patients with osteoporosis versus patients without osteoporosis. Four trials compared patients undergoing hormone replacement therapy versus patients without this therapy. Two trials compared patients receiving bisphosphonates versus untreated patients. In the overall meta-analysis, osteoporosis was a weak predictive factor of implant loss [odds ratio (OR): 1.8; 95% confidence interval (CI): 1.4-2.4].
Conclusion: These data suggest that osteoporosis should be considered as a possible risk factor in implant dentistry; however more clinical studies with a higher level of evidence are necessary. Moreover, the impact of the pharmacologic osteoporosis therapy may require more attention.