Featured Review Article Effect of bisphosphonates on orthodontic tooth movement in osteoporotic patients: A review

Journal of the World Federation of Orthodontists

Volume 7, Issue 2, June 2018, Pages 49-55

Highlights

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Due to the lack of scientific evidence, OTM in patients exposed to BPs is still unpredictable, and risk stratification should be performed.

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Altered bone metabolism and the higher risk of potential side effects should be considered in treatment planning, especially in extraction cases or high-risk patients.

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Longer treatment duration, decelerated OTM and, incomplete space closure in patients with initial spacing or extraction, and poor root parallelism should be expected.

Abstract

Background

This review discusses the side effects of bisphosphonates (BPs) in orthodontic tooth movement (OTM) with the main focus on suggesting key aspects for the clinical management of patients with osteoporosis by orthodontists.

Methods

Studies were selected through a search of the PubMed electronic database. The keywords used for the search were BPs, tooth movement, orthodontics, osteoporosis, and bone remodeling. The search was restricted to English-language articles published between 2001 and 2017.

Results

This article provides updated information about the mechanism of action of BPs; their effects on bone metabolism, particularly with regard to OTM; oral radiographic considerations in the osteoporotic patient; and the potential use of bone turnover biomarkers from oral fluid as predictors of bone remodeling and key aspects for the clinical management of patients with osteoporosis by orthodontists and dentists.

Conclusions

The interactions of BPs and oral/maxillofacial tissues with a high bone turnover rate such as maxilla or jaws can influence the success rate of dental procedures that involve bones around the teeth, such as extractions, periodontal surgery, and OTM.