Dental implant before bisphosphonate therapy

Discussion in 'Oral Surgery' started by Xoxatpl, Jul 20, 2018.

  1. Xoxatpl

    Xoxatpl

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    I have metastatic prostate cancer and am looking at IV bisphosphonate therapy. I also had 13 and 14 extracted recently and would like to get implants. How long should I wait after the implants are done should I wait before starting the bisphosphonates?
     
    Xoxatpl, Jul 20, 2018
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  2. Xoxatpl

    MattKW Verified Dentist

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    The implants normally go in ~3 months after the extractions, then wait another 3 months to allow bone to adhere. The abutments and crowns on top of the implants can be done any time after this as they don't affect the bone. Make sure all your other teeth are in excellent condition, especially periodontal disease. But if the doctors want you to start bisphosphonates sooner, then maybe that has to take precedence over implants. Talk to dentist and oncologist.
     
    MattKW, Jul 20, 2018
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  3. Xoxatpl

    honestdoc Verified Dentist

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    Sorry to hear about your metastatic prostate condition. Have you and your medical team considered immunotherapy (biologic therapy)? IV bisphosphonates have so many devastating oral side effects. Implants can be very difficult to integrate properly and to sustain it after IV bisph may result in guarded prognosis.
     
    honestdoc, Jul 20, 2018
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  4. Xoxatpl

    Xoxatpl

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    Even if i wait 3 months after implants are complete to begin bisphosphonate therapy?
     
    Xoxatpl, Jul 20, 2018
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  5. Xoxatpl

    honestdoc Verified Dentist

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    After your implants have fully healed/integrated (after 3-4 months or longer), to sustain them during IV bisph is very unpredictable and guarded. Again, try to consider alternatives to IV bisph.
     
    honestdoc, Jul 20, 2018
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  6. Xoxatpl

    MattKW Verified Dentist

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    All the studies I found are of taking bisphosphonates BEFORE implants are inserted (1) and (2). I couldn't find any studies that relate to bisphosphonate treatment AFTER implants have been inserted so I assume it would be similar to normal maintenance of natural teeth; there seems to be no reason not to do so. Therefore, I'd get the implants before started IV, if the IV can wait - talk to your oncologist; the cancer comes first.
     
    MattKW, Jul 21, 2018
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