Abstract：
Dental implants are a predictable option to replace missing teeth. Patients on antiresorptive medications used to treat disorders associated with bone resorption may need dental implants to replace missing teeth. The data on implant failure in patients on antiresorptive medication requiring dental implants, is conflicting and limited. This systematic review aims to investigate if antiresorptive medications have any clinical impact on dental implant survival. Electronic databases were searched until May 2020. The focus question (PICOS): Participants: humans, Interventions: implant placement surgery in patients on antiresorptive medication, Comparisons: patients on antiresorptive medication vs control (patients not on antiresorptive medication), Outcomes: implant survival, and Study design: clinical studies. The protocol of this systematic review was registered in PROSPERO (CRD42020209083). Fourteen nonrandomized studies were selected for data extraction and risk of bias assessment using the ROBINS-1 tool. Only studies with a control were included for the meta-analysis, 8 articles were included in the meta-analysis using implant-level data, and 5 articles were included in the meta-analysis using patient-level data. There was no statistical significance between the 2 groups at the patient level based on 265 patients. However, there was a statistically significant difference at the implant level based on 2697 implants. Therefore, antiresorptive medications, mainly bisphosphonates (BPs), may significantly contribute to implant failure. Antiresorptive medications, especially BPs may reduce implant survival and impair the osseointegration of dental implants. Failed implants in patients on BPs may not lead to osteonecrosis and may be replaced with success.
摘要：
牙科植入物是替代缺失牙齿的可预测选择。使用用于治疗与骨吸收相关的疾病的抗吸收药物的患者可能需要牙科植入物来替代缺失的牙齿。需要牙科植入物的抗吸收药物的患者植入物失败的数据，是矛盾的和有限的。本系统评价旨在调查抗吸收药物是否对牙科植入物的存活有任何临床影响。电子数据库一直搜索到2020年5月。焦点问题（PICOS）：参与者：人类，干预措施：接受抗吸收药物治疗的患者植入手术，比较：服用抗再吸收药物的患者与对照（未服用抗再吸收药物的患者），结果：植入物存活，和研究设计：临床研究。本系统评价的方案在PROSPERO（CRD42020209083）中注册。选择14项非随机研究进行数据提取和使用ROBINS-1工具评估偏倚风险。荟萃分析仅包括具有对照的研究，使用植入物水平数据的荟萃分析中包括8篇文章，5篇文章被纳入使用患者水平数据的荟萃分析.在基于265例患者的患者水平上，两组之间没有统计学意义。然而,基于2697个植入物,植入物水平存在统计学上的显著差异.因此,抗吸收药物，主要是双膦酸盐（BPs），可能会导致植入物失败。抗吸收药物,尤其是BPs可能会降低种植体的存活率并损害牙种植体的骨整合。BPs植入失败的患者可能不会导致骨坏死，可能会成功替代。
