MANDIBULAR OSTEONECROSIS RELATED TO THE USE OF BIPHOSPHONATES AND ITS IMPACTS ON REHABILITATION WITH DENTAL IMPLANTS

Abstract

Medication-related osteonecrosis of the jaw associated with bisphosphonate use is a clinical condition of multifactorial etiology, resulting from the use of antiresorptive drugs, characterized by impaired bone healing and frequently related to invasive dental procedures, such as dental implant placement. The aim of this study was to investigate, through a literature review, the relationship between bisphosphonate use and the risk of developing jaw osteonecrosis, with emphasis on implant success, associated risk factors, and clinical implications. Articles published between 2021 and 2026 were selected from the PubMed database using the descriptors “Bisphosphonate Associated Osteonecrosis of the Jaw”, “Osteonecrosis”, “Bisphosphonate”, and “Dental Implants”. Based on the analysis of the studies, it was observed that although patients using bisphosphonates do not show a significant increase in implant failure in some contexts, there is a relevant association between the use of these drugs and the development of osteonecrosis, especially after surgical procedures. Factors such as route of administration, duration of use, drug dosage, advanced age, presence of peri-implantitis, and implant characteristics directly influence this risk. Furthermore, discontinuation of the drug for prolonged periods has shown a potential protective effect. Despite evidence suggesting that implant placement may be safe in certain cases, there are still divergences in the literature regarding the predictability of these procedures. Therefore, the importance of a careful, individualized, and evidence-based clinical approach is emphasized in order to minimize risks and optimize therapeutic outcomes.