Dental implants

Dental implant placement should be avoided in patients who are being treated with high dose anti-resorptive or anti-angiogenic drugs for the management of cancer.

Implant placement is not currently contraindicated in patients with osteoporosis. However, there are reports of MRONJ in patients with dental implants. 

The overall risk in the osteoporosis patient group appears to be low and reports of MRONJ are less frequent in patients whose dental implants were placed before bisphosphonate drug treatment commenced.

For patients who have implants placed during or after bisphosphonate drug treatment, MRONJ has been observed both shortly after implant placement or a significant time after the procedure.

There is no data on implant survival in patients treated with denosumab.

  • Inform patients with dental implants placed prior to commencement with anti-resorptive or anti-angiogenic drugs, of the small risk of spontaneous MRONJ at those sites and provide information on how to minimise their risk, for example ensuring excellent oral hygiene at implant site(s).
  • Inform osteoporosis patients who consider dental implants during or after treatment with anti-resorptive drugs of the risk of compromised bone healing and MRONJ following the procedure and the additional small risk of long-term implant failure. Provide information for those patients who choose to go ahead with the procedure on how to minimise their risk, for example ensuring excellent oral hygiene at implant site(s).