The relationship between implant stability and bone health markers in post-menopausal women with bisphosphonate exposure.

Objectives: The authors assessed the relationship between implant stability and bone turnover markers in patients with and without a history of bisphosphonate (BP) exposure for treatment of osteopenia/osteoporosis.

Materials And Methods: One dental implant site was evaluated in 58 post-menopausal women with a spectrum of bone health in a "best practice" prospective cohort study. Each site had a previous or simultaneous bone augmentation procedure. BP exposure at enrollment was categorized as "never" or "past/current" exposure. Implant stability was assessed by resonance frequency analysis (RFA ISQ) at surgery and 8 weeks post-implant. Bone turnover markers, C-telopeptide collagen crosslinks (sCTX) and procollagen -1 N-terminal telopeptide (P1NP), were measured pre-treatment, 1, and 8 weeks following implant surgery.

Results: Mean age was 62.4 ± 6.8 years; 66 % were osteopenic/osteoporotic. Average RFA ISQ at placement for all participants was 63.5 ± 11.3, at 8 weeks post-surgery 74.2 ± 9.4 (p < 0.01). Among "past/current" BP users, there was a significant negative correlation between RFA ISQ values at 8 weeks post-implant placement and sCTX and P1NP values at 1 week (ρ = -.65 and ρ = -.55, respectively; p < 0.01) and 8 weeks (ρ = -.64 and ρ = -.52, respectively; p < 0.05).

Conclusion: RFA ISQ values increased between implant placement and 8 weeks post-surgery demonstrating successful osseointegration. Lower bone turnover was associated with better implant stability among patients with a history of BP exposure.

Clinical Relevance: Further investigation of the relationship between BP exposure and implant stability is warranted in a larger population, as results may strongly impact on clinical practice decisions.