Browsing by Author "Rebelo, Cristiana Gomes"
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- Bisphosphonates and their influence on the implant failure: a systematic reviewPublication . Rebelo, Cristiana Gomes; Fernandes, Juliana Campos Hasse; Bernardo, Nuno; Couto, Patrícia; Fernandes, Gustavo Vicentis OliveiraObjective: The goal of this systematic review was to study the relationship between the use of bisphosphonates (oral or intravenous) and its effect on implant osseointegration. Methods: The focused question was “In patients medicated with bisphosphonates and who underwent surgery to place dental implants, what is the influence of that medication (of different generations) on the failure of dental implants (O)?” Following specific eligibility criteria, four databases (PubMed/MEDLINE, Scopus, Web of Science, DOAJ) were electronically screened to search the articles. Specific MeSH terms were used in combinations with Boolean Operators “AND” and “OR” for the research. In addition, a manual search was done. The data extracted were the (i) author, (ii) year of publication, (iii) country, (iv) research question, (v) study design, (vi) patient information, (vii) the number of patients included, (viii) patient/implant status, (ix) the number of implants evaluated, (x) type of implant, (xi) risk factors, and (xii) findings obtained. Moreover, the following were also registered: the (i) type, generation, duration, and route for BP administrated; (ii) the presence of any systemic condition and drug treatment; (iii) follow-up (months); and (iv) implant failure rate (%). The quality assessment of the included studies was carried out using the Modified Newcastle–Ottawa scale. Results: A total of 491 articles were found (183 in PubMed/MEDLINE, 171 in Scopus, 65 in Web of Science, and 72 articles in DOAJ), and 17 articles were considered for full-text reading. After the exclusion of 3 articles, 14 were included in this systematic review (11 case reports, 2 retrospective, and 1 prospective study). The reasons for the bisphosphonates intaking included osteoporosis, multiple myeloma, breast cancer, knee cancer, and osteogenesis imperfecta. The oral administration involved Alendronato (eight studies), Risedronate (three studies), and Ibandronate (three studies); whereas the intravenous administrations were Zoledronate (seven studies), Clodronato (one study), and Pamidronato (three studies). The duration of use of bisphosphonates at the time of implant placement was diverse; it ranged from no interruption of bisphosphonate intaking up to its discontinuation for 2, 3, or 6 months before surgery, with respective use being resumed 1, 3, or 8 months after surgery. Antibiotic treatment (amoxicillin + clavulanic acid) was performed before the intervention in two cases and after the intervention in three cases. Finally, the percent of implant failure rate when intaking BPs had an average of 49.96%. Conclusions: Within the limitation of this systematic review, it was possible to conclude that a high mean failure rate of implant osseointegration (49.96%) was found, regardless of the generation of bisphosphonates used. Moreover, the failure rate was lower in patients using second generation bisphosphonates (Alendronate and Pamidronate) and was higher with the IV administration compared to the oral administration of bisphosphonates.
- A influência dos bifosfonatos na falha dos implantes dentários : revisão sistemáticaPublication . Rebelo, Cristiana Gomes; Couto, Patrícia Sofia Soares; Fernandes, Gustavo Vicentis de Oliveira; Santos, Nuno Bernardo Malta dosIntrodução: O edentulismo constitui uma condição clínica associada a constrangimentos psicossociais que provêm da deficiência a nível funcional e estético. A colocação de implantes dentários é uma solução amplamente difundida nestas situações. Contudo a osteointegração do implante parece encontrar-se dependente de inúmeros fatores, nomeadamente a toma de bifosfonatos, fármacos estes também frequentemente associados à osteonecrose dos maxilares. Objetivos: Verificar qual a influência dos bifosfonatos na osteointegração de implantes em pacientes que façam terapia com BFs e tenham sido submetidos a uma cirurgia de colocação de um ou mais implantes. Materiais e Métodos: A presente revisão sistemática foi elaborada de acordo com as guidelines PRISMA. Quatro bases de dados foram utilizadas: PubMED/MEDLINE, Scopus, Web of Science e DOAJ. Foram pesquisados de janeiro de 2000 até dezembro de 2021 (inclusive) artigos que tratam da questão PICO. Foram incluídos estudos em que os pacientes usavam bifosfonatos sistémicos e tivessem sido submetidos a cirurgia de implantes dentários. Ainda, ensaios controlados aleatórios, casos-controlo, series de casos, estudos retrospetivos e prospetivos foram incluídos na pesquisa. Resultados: Inicialmente obtivemos um total de 491 artigos em todas as bases de dados bibliográficas, após removermos os duplicados resultaram 277 artigos. Depois da leitura do título e resumo obtivemos 17 artigos para leitura integral, para avaliar a sua elegibilidade. Por fim, foram incluídos 13 artigos nesta revisão sistemática. Conclusão: Verificou-se um alto índice médio de insucesso na osteointegração de implantes (59%) em pacientes que usam bifosfonatos. A taxa de insucesso foi menor quando realizada a interrupção da terapêutica. Nos pacientes que não descontinuaram a medicação, a taxa de insucesso foi menor nos que faziam uso de BFs de 2ª geração. Fatores de risco como tabaco, diabetes e hipertensão foram relacionados com taxas de insucesso mais altas.