Dental Implant Failure and Medication-Related Osteonecrosis of the Jaw Related to Dental Implants in Patients Taking Antiresorptive Therapy for Osteoporosis: A Systematic Review and Meta-Analysis
Pooled result · Implant failureResult — go to the resultRelative risk 0.82 95% CI 0.52–1.28Authors' conclusion
The low-certainty evidence suggests that antiresorptive therapy for osteoporosis reduces dental implant failure. Bisphosphonates are associated with MRONJ in patients with osteoporosis receiving dental implants with moderate certainty.
Study context
- Population
- Patients with osteoporosis or osteopenia receiving dental implants; 5 databases searched (1946–2024)
- Participants
- 655 patients9 studies
- Comparison
- Antiresorptive therapy vs no antiresorptive exposure
- Outcome
- Dental implant failure
Methodological detailsrandom-effects meta-analysis, interventional and noninterventional studies, GRADE certainty assessment, Two reviewers independently screened titles, abstracts and full texts, Risk of bias: modified Ottawa-Newcastle scale; evidence graded with GRADE
- Random-effects meta-analysis
- Interventional and noninterventional studies
- GRADE certainty assessment
- Two reviewers independently screened titles, abstracts and full texts
- Risk of bias: modified Ottawa-Newcastle scale; evidence graded with GRADE
Pooled result
Implant failure
Relative risk
0.82
95% CI 0.52–1.28
P = 0.38
Antiresorptivesvs Unexposed
RR 0.82 (95% CI 0.52–1.28); P = 0.38
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Implant failure, sensitivity analysis at implant levelAntiresorptivesvs UnexposedVery low certainty | 0.53 (0.34–0.81) | P = 0.003 | |
| 0.20.5125Relative risk (log scale) |
Medication-related osteonecrosis of the jaw (MRONJ) in implant recipients
- Cases of MRONJ identified in implant recipients
- 186
- Pooled rate of MRONJ after implantation with antiresorptive exposure (21 cohorts)
- 0.5%
Safety
Risk-adjusted MRONJ with bisphosphonates (single report)
| aHR (95% CI) | P value | ||
|---|---|---|---|
| BisphosphonatesModerate certainty | 4.09 (2.75–6.09) | P < 0.001 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
- Risk-adjusted MRONJ with bisphosphonates (single report) — Additional MRONJ cases per 1000 patients with bisphosphonates
- 3
Original publication
Dental Implant Failure and Medication-Related Osteonecrosis of the Jaw Related to Dental Implants in Patients Taking Antiresorptive Therapy for Osteoporosis: A Systematic Review and Meta-Analysis. Endocr Pract. Published 10 June 2025. doi:10.
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